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PART 2: Dr. Aaron Kheriaty on ‘Biosecurity Surveillance,’ Perverse Vaccine Incentives, and Testing COVID-19 Vaccines on Children

Last week, in part one of our interview with medical ethics professor Aaron Kheriaty, we discussed natural immunity, vaccine efficacy, and his lawsuit challenging his university’s vaccine mandates.

Now in part two, we discuss perverse incentives involved in the vaccine rollout, the ethics of testing COVID-19 vaccines on children, and the rise of what he calls “biosecurity surveillance.”

Dr. Kheriaty is a professor of psychiatry at the University of California–Irvine’s School of Medicine and director of the Medical Ethics Program at UCI Health.

This is part two of a two-part series. Watch part one HERE.

Jan Jekielek: You mentioned the FDA decision-making around vaccines for five to 11-year-olds for children. You’ve even said that doing testing of vaccines for children in this age category is ethically questionable. I find that fascinating and important. Can you please outline what you mean? Just this overall picture and then specifically doing this test.

Dr. Kheriaty: When we talk about the ethics of doing scientific research on children, broadly speaking, there’s two categories or two types of research. One is what we call therapeutic research. Therapeutic research is research where the person enrolled in this study has a reasonable chance of benefiting from the study intervention.

Let’s take a medication, for example, new medication for, I’ll use depression because I’m a psychiatrist—new antidepressant medication. You enroll people in the phase three trial who have depression. And you have a medication that we haven’t proved yet works for depression, but we have some reason to believe that it works for depression.

The person enrolled in the trial has a 50/50 chance of getting randomized to either placebo or to the new medication that we’re testing. That kind of research with careful precautions in place can legitimately be done on children.

You have a child with childhood cancer, God forbid, and they’ve failed the usual chemotherapies. Their parents with the child’s ascent, not consent because the child can’t give consent, but with the child’s cooperation could be enrolled in a new clinical trial for a new cancer intervention for their leukemia if we have reason to believe that it might work for them.

Without this, they’re going to die. And I think most people could look at that situation and say, “Yeah, we don’t want to experiment on children if we don’t have to, but this is a case in which it would be justified.”

Then there’s non-therapeutic research. And by that I mean, not that we’re doing research on something that’s not a drug. You can have non-therapeutic research on a medication. And that would be the safety trial of the medication and healthy subjects to see what dose is tolerated and what side effects people have. And that kind of research is done. And it’s usually done on people that are compensated to some degree.

You can’t compensate them too much because that can amount to unduly coercing them. But you can reasonably compensate people for subjecting themselves to those risks of trying a new antidepressant medication, even though they’re not depressed to see… Monitored carefully in a hospital setting to see if it harms them; to see if it causes side effects before it’s rolled out in the next phase of studying efficacy.

Now we can’t do non-therapeutic research with children. We cannot enroll children in a study that is not going to benefit them. That is only going to benefit other people. That would be to instrumentalize the child, to use the child as a means to another end.

Can we do research on children? Yes, but only if there’s a reasonable chance that that child will benefit from the research. Based on what we know of COVID risks, the tiny number of children that have died of this illness is so small that it’s likely these are children that had some sort of immunodeficiency.

Again, the mortality for children is as close to zero as you get in medicine. For the vast majority of children, they’re not going to benefit from the vaccine. That’s non-therapeutic research. That subjecting a child is something that’s not going to help them. Why would we do that?

Are we doing that to try to protect older people on the hypothesis that maybe this will reduce the child’s chance of transmitting an asymptomatic infection to grandma? That’s to instrumentalize a child. That’s to use a child as a shield for an adult.

We can’t do that. No sane society should ever use children and subject children to risks to try to shield adults from some form of harm. Adults make sacrifices for the wellbeing of children, not the other way around. And no sane society, no society that still has its moral compass intact would propose anything like that. That’s one of the concerns about vaccinating this population.

The other concern of course, is that in states like California, the governor has already announced that as soon as one of the vaccines is authorized for children, there’s going to be a mandate requiring any child in public or private schools to get vaccinated. And if people think there’s pushback on vaccine mandates now from adults, when those mandates come for children, there’s going to be even more significant pushback from parents.

Many of whom got the vaccines themselves, whether because they wanted it or for the sake of convenience so they could go to work or they could trave., Who are very clear about risks and benefits for children and will not subject their child to known and unknown risks for almost no chance of benefit.

Mr. Jekielek: Given the known science around COVID impact on children in this age category and everything you’ve just said, how is this being considered?

Dr. Kheriaty: If you look at the data that the FDA recently considered, well, there’s several problems with the approach. One is that the clinical trial, the research that was done on children with these vaccines did not actually measure or look at clinically meaningful outcomes.

When you give a vaccine, what you care about is not that the vaccine boosted someone’s antibody levels. What you care about is, did the vaccine prevent a child from getting infected, especially in a symptomatic infection or a bad outcome like hospitalization or death?

Those are the clinically meaningful outcomes: symptomatic infection, hospitalization or death. There were not enough cases of COVID, there were not enough hospitalizations and there were not enough deaths in the study to meaningfully measure those things. There was a handful-

Mr. Jekielek: For obvious reasons.

Dr. Kheriaty: For obvious reasons, because children are not at risk for COVID. You’d have to do an enormous study of children to even pick up those exceptionally rare numbers to even be able to compare them to see if the vaccine got a tiny little nudge in those outcomes.

They used the lab values as a proxy for efficacy on the assumption that a boost in antibodies means a clinically meaningful boost in immunity. Well, that hasn’t been established in children, and that’s not sufficient to establish that children will benefit from these vaccines.

Another problem is that in terms of rates of adverse effects, after widespread critique of the various systems and how potentially unreliable it is, and correlation does not prove causation, they used, for example, myocarditis rates that were taken from VAERS reporting. Again, we don’t know, is that under reported by a factor of 10 or 50 or 100? That’s not a quantitatively clinically meaningful number. It’s not a good benchmark for comparison.

We know that vaccine efficacy declines at about four to six months. We’re already talking about boosters for the mRNA vaccines because of waning efficacy. How long if there is any benefit in immunity for children from the vaccines, which we don’t know, are they going to need boosters? If they need boosters every six months to a year, you’re not just talking about the myocarditis risk of a two-dose regimen. You’re talking about that two-dose regimen repeated over and over. Those risks become additive.

And since myocarditis risks were higher for the second dose than for the first, will they be subsequently higher for the third dose than the second and the fourth compared to the third? Also, when you’re looking at safety risks, you can’t just look at one outcome. Most of the attention went to this issue of myocarditis—myocarditis with COVID versus myocarditis with the vaccines. And that comparison was problematic for the reasons I’ve already mentioned and for other reasons.

But you have to look at the risk of myocarditis and all the other side effects. You have to look at the additive risks.

Mr. Jekielek: And some of which, of course, they’re not known because…

Dr. Kheriaty: Exactly. Precisely. Precisely. So at this stage, the level of evidence of safety and efficacy in that particular age group is very thin. It hasn’t been adequately quantified, so comparisons between COVID risks and the vaccine risks are not meaningful. There’s extrapolation from lab data to actual clinical outcomes that is hypothetical and unwarranted until it’s actually established and proven. These problems unfortunately are being sidelined.

There are pressures being placed on some of these agencies to get these things approved and to roll them out, and in some states then subsequently to mandate them. For a lot of Americans, this issue of childhood vaccination against COVID is going to be… Well, not vaccination per se, but mandates for vaccination are going to be kind of rubicon. I think it risks a lot of harm and mistrust and polarization.

That’s the last thing that our country needs at this point. We need to be able to come together, people need to be able to voice their concerns. People need to be able to stand up and look retrospectively and say, “Okay, it’s hard to play Monday morning quarterback and second guess what we did in 2020, but an honest assessment suggests that we made some mistakes and it’s important to acknowledge those.” That’s how you regain the trust of the American people.

And I think people will accept an honest assessment of past shortcomings or failures. I think what they won’t accept is people doubling down on failed solutions as the failures become more and more apparent so that they don’t have to walk those back or second guess them. In the interest of saving face and doubling down, you will only harm your credibility even more

Mr. Jekielek: And this isn’t actually academic for you. You have five kids, you have one son that’s nine, exactly in this age category that we’ve been discussing.

Dr. Kheriaty: Right. Now, we’re on the precipice of a situation in which we’re going to take that decision-making authority away from parents for a novel biologic intervention agent, a vaccine that was only recently developed. That was only tested in a small number of children—1,500 children in the intervention arm in the study. That was again, short-lived, not very long.

So we’re not only not going to allow parents to make a decision, we’re not going to allow them to refuse this particular intervention, where there are, to my mind, very compelling reasons that parents may want to decline vaccination for their children for this particular illness.

Mr. Jekielek: Where is this taking us as a society in your mind?

Dr. Kheriaty: I worry that there have been a series of novel proposals that have rolled out since the pandemic began that have asked, and in some cases demanded that individuals do things that under any other circumstances they would not accept. So the idea of having to show a QR code or a card verifying that I have received a particular medical intervention before I can get on a plane, get on a train, go to a restaurant or access basic public goods and services would have been unthinkable two years ago.

No one would have accepted being turned away from a public space on the basis that they had or hadn’t taken medication or accepted a particular medical intervention. And now we’re getting used to that notion.

Look, you may have been the first in line for the vaccine. You may have been one of the folks that was very eager to receive this medical intervention. Great. As long as you had adequate informed consent, you made your own decision. I’m all in favor of that.

But once people get used to having to show these sorts of credentials just to participate in public life, in economic exchange, in education, in the workplace and sending their kids to school, the infrastructure is then in place to nudge people to do other things that the public health establishment decides are necessary. So there are mechanisms being put in place for biosecurity surveillance.

What’s happening is that people are being put in a position in which they’re required, if they want to just keep living a normal life, they’re required to give up and to disclose protected health information, for example. So it’s become commonplace for complete strangers to ask you about your vaccination status.

To me, that’s like me turning to a stranger that I just met or someone who wants to sit down in the restaurant that I’m running and asking them if they’ve ever had syphilis or gonorrhea. That would be intrusive, entirely inappropriate and obvious invasion of their privacy. And when you put the question in those terms, it’s sort of obvious to people. It can shake them out of their stupor. But this is in principle, the same kind of thing and yet it’s become, in the last year, socially acceptable.

Mr. Jekielek: Not to belabor it, but basically, extensively, the people would say, “Well, it’s acceptable because it’s for the greater public good.” This is always kind of the mantra for why this exceptional situation is acceptable in this case.

Dr. Kheriaty: And in fact, there are some models that suggest this false sense of security that many people have after getting vaccinated, because they haven’t been given accurate information about what the vaccines can and cannot do. They mistakenly believe that before I got vaccinated I avoided going and visiting grandma, because she would be at high risk if she got infected with this virus. But now that I’m vaccinated, I can go see her, no problem. I don’t have to worry about it.

Not only are you still capable of having an asymptomatic infection that you transmit to grandma after you’ve been vaccinated, but you may actually be at higher risk of unknowingly exposing her. Because what can the vaccines do? They lower your risk of more severe symptoms, so you might have an infection where your fever or your cough is not as apparent, and so you think it’s perfectly safe to be around other people. And in response to that false sense of security, people change their behaviors.

They engage and interact with more people who may be vulnerable. They live their lives in such a way that they may actually expose people more to the virus. Especially again, you can explain this to people, but if someone who’s vaccinated gets access to public spaces where they’re around other people and someone who’s not vaccinated doesn’t get access to those spaces, that sends the obvious message that you’re a person who’s safe to be around and you’re not a risk to others or a risk to society.

We’re communicating the message that the unvaccinated are unclean. We’re treating perfectly healthy people as though they’re a real and imminent threat, and we’re perhaps giving other people the false sense of security that they pose no risk to the people around them in terms of transmitting this virus.

There are reasons to believe that the system that we’ve set up is not only taking away people’s basic rights and freedoms and in the future can be used for all kinds of other decisions, and all kinds of other nudges, and all kinds of other coercive mandates. But it’s not even achieving the ends for which it was supposedly put in place to begin with in terms of getting a better handle on this particular illness.

Mr. Jekielek: And I’ve seen multiple examples of this in various social media of people suggesting that people in terms of general availability of medical care, for example, be treated differently based on their vaccination, or unvaccination status. Which I thought was frankly, almost unbelievable, but this wasn’t just one voice.

Dr. Kheriaty: The idea that a physician would refuse to treat a patient based upon that patient’s healthcare decision in regards to this particular intervention is wrong on many levels. First of all, physicians exist, and were trained, and were given access to certain forms of knowledge. And we’re given a monopoly on certain privileges like prescribing medications. We’re given this by society so that we put those skills and that knowledge to use in service of sick people.

So the notion that we would refuse to treat someone because they may be at statistically higher risk of one particular illness is utterly contrary to any sound hippocratic understanding of the purpose of medicine and the role of a physician. And you can extrapolate this to other settings within healthcare. The idea that a physician would refuse to treat someone who’s obese and failed to lose weight. Or someone who is a smoker and has not been able to quit or has chosen to continue that habit.

People engage in behaviors all the time that put them at higher risk for certain negative medical outcomes, and physicians continue obviously to treat those patients all the time. Medicine has always treated people with infectious disease during pandemics, even if that puts the physician at somewhat higher risk. The other proposal that’s been not only floated, but actually put in place recently in many healthcare systems is to refuse organ transplants on the basis of vaccination status.

That goes for organ donors and organ recipients on the higher statistical likelihood that the person after getting the transplant might get infected and die of COVID. And again, we don’t do that with organ transplants. If the patient is engaging in a behavior that’s directly going to cause that intervention not to work, then we can deny them that intervention.

A patient who says, “I’m not going to take my immunosuppressive medications after I get the new kidney, because it’s just too much of a nuisance.” Well, we would be justified in saying, “You’re not a good candidate for the kidney transplant because part of making this particular intervention work for you is that you got to stay on this regimen for the rest of your life.” But the proposal of refusing someone who’s unvaccinated is entirely different from that.

That would be like, I don’t know, refusing someone who drives race cars for a living a transplant that is the only thing that will save their life because after he gets his new liver, he’s going to go back and continue running around the race track at 200 miles an hour.

And that puts them at higher risk of mortality than other people his age. Well, no, we would never do that to a person. We would never demand a person give up that profession or even that hobby because it would slightly change statistical outcomes for what’s going to happen to them over the next 10 years.

And yet this has been embraced and accepted when it comes to vaccine status. And I think we will look back on what has been put in place in relation to vaccine status over the last year. We will look back on this with shame and scratch our heads and really wonder what were we thinking?

Some basic principles of medical ethics were simply set aside in a climate of fear and under this condition of emergency, when it suddenly became possible to entertain ideas and proposals that two years ago, we would never dream of.

Mr. Jekielek: You mentioned that you think the FDA and maybe some other agencies are under some kind of pressure for the outcomes that we’re seeing. Where does this idea come from?

Dr. Kheriaty: Sure.

Mr. Jekielek: Where do you see these pressures? Is this something substantial, is that theory?

Dr. Kheriaty: And there have been several dynamics at work in this pandemic that make the work of public health institutions subjected to forces that are not entirely cool and objective and dispassionate.

One of the factors is simply that those in power, when they see a problem, they want solutions. So looking to a public health official as a governor or as a county board of supervisors and saying, “Well, we got to do something about our COVID numbers or about our hospitalizations.”

And having that person respond to you, talking about the limitations of what we can do, and that some things are actually outside of our power and outside of our control. Well, that’s not a person that a politician is going to listen to for very long. They’re going to want someone who’s proposing answers and interventions, even if those interventions haven’t proven to be very effective. At least we’re not sitting back on our heels, we’re doing something.

I think one of the things that happened to us collectively and psychologically at the beginning of the pandemic was that we were hit with something novel—a new virus that we didn’t understand. It’s an invisible, hidden pathogen. The notion grows in people’s minds that any individual, even if they look healthy can be a potential threat that I need to defend myself from, which made the idea of social distancing and lockdowns, I think easier to swallow. So there was a lot of fear and that fear was very understandable.

And for people that had put a lot of stock in the promise of science and technology solving all of our social problems, the idea of progress is laudable—progress through science and technology. But any idea if taken to an extreme can become an ideology. And the ideology that science and technology can solve all of our problems is just that… I think it’s a false hope. Nature can throw things at us all the time, whether it’s a tsunami, or an earthquake, or a novel pathogen that we can’t control.

So there’s a strong psychological impulse to not only want to be able to exert control, but to be able to exert control precisely through advancements in science and technology. Which is one of the reasons I think psychologically that the vaccine as The Solution, capital T, capital S solution, the only solution to solve the pandemic problem fits into a particular way of seeing the world, in a particular way of understanding the world that says, “What we know is what we can make. What we know is what we can control.”

When the pathogen first emerged, we didn’t have a way to control it. And almost as a nod to the power of science, we had to hit the pause button and put everything on hold—the entire society, the entire economy on hold until science could catch up to this thing. That was the implicit reason for the lockdowns.

They didn’t say this in the beginning because lock down until we can get a safe and effective vaccine would not have been palatable to people. They would raise their hand and ask the obvious question, how long is that going to take? And what are going to be the consequences of that if we keep waiting for that?

But that was the implicit hope and that’s in fact more or less what we did. And I think in part, that was an attempt to reassert the notion that if we could just study the problem and put our best minds to work, we can come up with the silver bullet, the magic potion that’s going to fix everything.

You can’t place that kind of hope in science and medicine. Look, I’m a physician, I love medicine. I prescribe medications all the time. I’ve taken all of the vaccines on the vaccine schedule, except for this one because I have remaining questions about it—because I have natural immunity.

But medicine and any particular medical intervention can’t do everything for you. It can’t fix a problem this complicated. The solution to the COVID pandemic has to be multifaceted, and yet we’ve had a kind of tunnel vision that is focused only on one intervention or one set of interventions or one type of intervention as the be-all end-all solution. There are many things that we could have been doing during the lockdown. I’ll give you a simple example.

People are home. They’re not working as much. A lot of folks had more time on their hands. What did we know at that stage of the pandemic about modifiable risks, while the greatest risk by far was age? Can’t modify that. After that, obesity was among the most significant risks. That’s something that’s potentially modifiable.

There are other things that we can do to strengthen our immune systems from vitamin D, to regular exercise, to various interventions that can lower stress. We know stress plays a very significant role in diminishing our immune system’s effectiveness.

So all kinds of things that could have been done to strengthen our immune systems, why weren’t we hearing from public health officials messaging about those interventions? Why didn’t public health authorities start streaming exercise routines that everyone could do? That’s a way to help people improve their health in general.

Because of course public health is not just about one disease or one pathogen, it’s about the health of people as a whole. The fact that we ignored the mental health effects of lockdowns is another major shortcoming of our pandemic response.

I wrote a piece in Public Discourse last year called “The Other Pandemic,” which was about the lockdown mental health crisis, the rising rates of depression, anxiety, substance use disorders, domestic abuse, trauma, and sadly, suicide.

The serious adverse consequences that I as a psychiatrist was seeing and treating firsthand, but also the research which was coming out at the time was suggesting a major negative impact of the lockdowns. Those issues were never really brought into a meaningful public health conversation or debate. They were ignored and they were sidelined.

These other interventions that could have been done—non-pharmaceutical interventions. Yeah, nobody’s going to get rich doing these things, but certainly, public health officials could have done a lot more to encourage people in that regard and that would’ve probably saved lives.

Mr. Jekielek: The thing that I keep thinking about, coupled with the emergency use authorizations of these vaccines very quickly developed is this protection from liability. And in that sort of a situation, people behave differently. Tell me more about your thoughts there.

Dr. Kheriaty: Folks that are hesitant or have concerns about the vaccine, as we know, some of them are spinning all kinds of theories from the interesting to the downright bizarre about where’s this push to vaccinate everyone coming from?

But I think one need not get very complicated to understand why there may be perverse incentives at work that are built into the system as it’s currently set up. I don’t think we have to attribute ill-will or even greed, although that may be operative in the context of Big Pharma and so forth.

But if you just look at what’s happened, specifically with vaccines in the United States, pharmaceutical companies several years ago, this has been in place for a while, convinced the federal government that they shouldn’t be liable for any harms or vaccine-related injuries that their products cause.

So they are protected from liability, not just for the COVID vaccines, but for other vaccines as well. The federal government has set up an agency to investigate vaccine-related serious injuries to compensate those families, in exchange for signing a nondisclosure agreement so that they don’t talk about their vaccine injury.

Which has its own set of ethical problems I think associated with it. But in any case, the company who produces this product is not responsible for the harm that the product might cause. The proposed reason why they needed this indemnification against liability for vaccines is supposedly that they’re too expensive to develop and they wouldn’t be sufficiently profitable.

I think we now have reason to doubt. I think Pfizer and Moderna have minted at least nine new billionaires just this year from the rollout of their mRNA vaccines, so the vaccines are plenty profitable. And I think most Americans would scratch their heads if a car company was no longer liable for safety issues with the vehicles that they were producing. We would see that as obviously not right.

So you’re setting up a system here where the pharma company doesn’t have the natural checks on their own studying and development of the safety of their product. They’re motivated as a corporation should be by the profit motive. I don’t fault them for that. They have a fiduciary responsibility to try to increase their company’s values for stakeholders. That’s fine, everyone understands that.

But then the question is, if they’re producing a product that’s injected into people, and can have good and bad potential pharmacological effects on people, [then] there has to be some checks on the system to make sure that the profit motive doesn’t override other concerns.

And one of those checks is just simply making the company liable for the benefits and harms that its product is going to cause. So somehow, we’ve decided that we don’t need to do that in the case of vaccines. We’re missing that check on the system.

You combine that with the context of the pandemic, in which the clinical trial was shortened even further than it would be for other vaccines under ordinary circumstances. And you don’t need any sort of grand conspiracy to see that there may be… we may be setting ourself up for problems here.

We don’t know the long-term risks of the vaccines. There’s no possible way we could know the long-term risks to the vaccines. Anyone who tells you they know is either just uninformed or they’re not telling the truth.

Mr. Jekielek: We’ve had people who have had vaccine harms talking about the fact that no one’s really listening to their cases. And I think as you suggested earlier, talking about these things as a professional is not met with a positive response often.

Dr. Kheriaty: Yeah. I don’t see this anywhere else in medicine, outside of vaccines. The medications I prescribe routinely have risks associated with them. And sometimes they are rare, but potentially seriously harmful risks. And people can get online and join other groups to talk about negative experiences they’ve had taking an antidepressant medication or an anti-psychotic medication or a mood stabilizing medication. And they have the right to do that.

Do I think sometimes patients who have had a negative experience don’t adequately contextualize that? And some people who go to that as the only source of their information might not have a balanced view of the risks and benefits of those medications? Sure. But the notion that I would shut down a Facebook group of people that are talking about their experiences with the medications that I prescribed is preposterous.

Of course, they have the right to do that. Of course, they have the right to, at least have the sympathy and understanding of fellow travelers who have also been harmed by medical interventions. Every medical intervention has risks, we know that. Vaccines are no exception to that—vaccines have risks as well. Does that mean we shouldn’t use those medical interventions? Does that mean that we shouldn’t use vaccines?

No, but it means that we have to carefully assess the risks and benefits for each individual that’s getting that intervention and give them the freedom to decide whether or not they want to assume the risks for the sake of the potential benefits.

But what’s happening now is social media is literally shutting down groups of people getting together to talk about their experience with these vaccines, groups that oftentimes have tens or even hundreds of thousands of people before somebody pushes a button and turns off their ability to congregate online and to communicate with each other.

This is not a laudable development for a free society. You know what I mean? We have support groups for patients with terminal cancer. These are the patients for whom surgery, chemotherapy and radiation didn’t work. Are we afraid that they’ll gather together and talk to one another about dealing with this illness and dealing with the side effects of their ineffective chemo because it might dissuade other people from getting chemotherapy? No, that would be absurd. Why is it acceptable in the case of vaccines?

Mr. Jekielek: What do you see as the best way forward as we finish up?

Dr. Kheriaty: I think the best way forward is to open up the possibility for meaningful conversations. People need to be able to ask questions. That’s central to what it means to live in a free society.

The common feature of all totalitarianisms is not men in jackboots or concentration camps—as horrifying as all those features are, if you look at all the totalitarianisms of the 20th century, what all of them shared in common was a social climate in which people were forbidden from asking certain questions.

There are certain questions that during the COVID pandemic seem to have been forbidden. Certain questions about public health decisions, certain questions about data, and information, and evidence. So we need to create a climate in which open, sincere, transparent conversations can start happening. People are going to go looking for information, and if you want them looking to what you consider to be credible sources, then you need to start making your sources more credible.

You need to be willing to admit when you’ve made mistakes, you need to be willing to admit when the science is complicated. You need to be willing to acknowledge when there are things that we know and things that we don’t know. And communicate that to the American people and allow people to ask questions.

Allow people to make judgments about their own decision-making and their own health and welfare and that of their families. And stringent heavy-handed mechanisms to try to increase social control when persuasion or downright propaganda haven’t worked, to my mind is a recipe for disaster.

So, I think Americans need to sit back and ask themselves, “Where is my own limit in terms of the personal freedoms that have already been taken away from me and the freedoms that may be taken away from me now or in the future? Where’s my threshold for saying, ‘Enough’? This far, but no further?”

If a person doesn’t have that threshold, I’m not saying they’ve reached it yet, but if they don’t know in principle what they would be unwilling to give up in the face of pressure, they should ask themselves some hard questions about why is it that I would be willing to relinquish my own judgment, my own rationality, my own free decision-making in the face of social pressures?

And if upon examination of their own life and what’s happened to them since the beginning of the pandemic, they decide no, that line has already been crossed. Then I think it’s time for them to stand up and reassert their rights. Their right to informed consent, their right to work and to travel with reasonable safety precautions in place. But without undue burdens that are not benefiting anyone. People can trust their own judgment, they should start trusting their own judgment more.

They should study the problem. They should try to get informed. They should listen to both sides of all of these debates. But at the end of the day, I think folks need to reclaim their own ability to make judgments on behalf of their own health and on behalf of those that are entrusted to them, parents, for their children being the prime example of that.

Mr. Jekielek: Well, Dr. Aaron Kheriaty, it’s such a pleasure to have you on.

Dr. Kheriaty: Thanks.

This interview has been edited for clarity and brevity.

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