Making Sense with Sam Harris #436 — A Crisis of Trust
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Oct 3, 2025 
Michael Osterholm, an infectious disease epidemiologist with over 50 years of experience, discusses his new book about preparing for future pandemics. He shares critical lessons from the COVID-19 response, highlighting mistakes like blanket lockdowns and the need for better respiratory protection. Osterholm explains the difference between airborne and droplet transmission and warns of the potentially lethal 'Big One' pandemic. He emphasizes the importance of focusing on preparedness rather than getting lost in debates over the virus's origins.
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Early Calling And Long Career
- Michael Osterholm decided in seventh grade to become a “medical detective” after reading New Yorker outbreak stories.
- He trained in infectious disease epidemiology and has worked on outbreaks and advisory roles for decades.
Early Warning And Accurate Projection
- Osterholm warned early that COVID-19 was the next pandemic and predicted ~800,000 U.S. deaths within 18 months.
- He links rapid airborne spread and presymptomatic transmission to the scale of the catastrophe.
Aerosol Versus Droplet Transmission
- Aerosol transmission differs from droplet transmission because tiny particles remain suspended and travel far.
- Osterholm emphasizes aerosols can infect people at distances where droplet precautions fail.
