A weekly discussion with those leading the Covid-19 global response and fighting the pandemic in the United States.
Dr. LaQuandra S. Nesbitt
Dr. LaQuandra S. Nesbitt, Director of the DC Department of Health, returned as our guest to share her reflections. Her view of President Biden’s six-point plan? Tying vaccination to sustained employment is the next phase: mandates will bring about an uptake in vaccines. The rising emphasis on monoclonal antibodies is a “huge initiative” that brings about a reduction in hospitalizations. The President negotiating access at-cost to over-the-counter test kits is a similarly big step. DC has avoided the worst outcomes seen elsewhere in the United States by “planning for the worst.” Plus there has been relative unity: “residents have done what we have asked them to do.” “At times of adversity, this city rises to the occasion.” Top challenges? Vaccine disinformation regarding infertility creates “myths” that remain “inexplicably” powerful. Managing confusion over boosters is “tricky” in the absence of a “single voice, single message.”
Dr. LaQuandra S. Nesbitt has served since January 2015 as Director of the District of Columbia’s Department of Health in Washington, D.C.
Tom Bollyky: “We Don’t Know How This Started”
Tom Bollyky joined us on the occasion of our 100th episode to reflect on President Biden’s six-point re-set of US pandemic policy, unveiled September 9, and to discuss what can be done to break the deadlock over determining the origin of SARS-CoV-2. President Biden’s patience has clearly run out, and the new approach, heavily reliant on mandates, will stir political blowback, litigation, and defiant disobedience which may slow progress versus accelerate momentum. It’s “not a happy day” when people will be “pushed into a corner.” It’s disappointing that the private sector did not earlier do far more. Our national narrative may however improve, as higher rates of hospitalization of children deflate the individual freedom argument. On the origins controversy, it is “utterly unsurprising” that the US intelligence review was inconclusive. The origin issue is indeed terribly important, at this historic “policy moment,” since without resolution, we are blocked in our prevention approaches. We are in a “dark environment” and there is no prospect for progress in global health unless we find a basis for cooperation between the US and China. In the meantime, we should prioritize moving ahead with more rigorous lab safety standards and end wildlife trade and wet markets.
Thomas J. Bollyky is the Director of the Global Health Program and Senior Fellow for Global Health, Economics, and Development at the Council on Foreign Relations.
Larry Gostin – “Mandates may be the only way out of this”
Professor Larry Gostin joined us for a spirited conversation of where America as a country stands today, almost two years into Covid-19. Human ingenuity and scientific gains have been “astounding,” while our preparedness, in the face of such a “wily enemy,” has too often been “abysmal.” We experienced shock when the first wave that began in Wuhan landed at our shores, CDC bungled tests, the Trump administration stoked anti-Asian hatred and politicized essential tools – masks, vaccines, and temporary lockdowns. Public health messaging too often has been “appalling," as CDC’s scientific leadership has stumbled. Now, in late 2021, we face the danger of dividing our society into two opposing camps, the vaccinated versus the unvaccinated. The Biden administration has refused to take up vaccine credentialing, a significant mistake. It has also shown remarkable leadership in trying to overcome vaccine hesitancy and refusal, and now must turn increasingly to mandates.
Larry Gostin is University Professor and Director of the O’Neill Institute for National and Global Health Law at Georgetown Law.
Dr. Anthony Fauci: Tour d’Horizon Aug 3, 2021
In conversation with Steve Morrison on August 3, Dr. Fauci began by laying out the $3.2b Antiviral Program for Pandemics. Its dual aims are quick and long-term wins. The optimal antiviral: a single pill, oral, that early in infection stops replication. Any solution has to be grounded in equity of access, at home and abroad; requires a massive increase in testing; and will rest on combination therapy to combat variants. The initial $3.2b, it is hoped, achieves success that fuels higher future investments. Private industry and academic partners are key to rapid gains and building sustainable R&D capacity. Beyond the APP, how to arrest the “pandemic of the unvaccinated? We need a national “uniformity of approach” on masks, vaccination levels of at least 1-2 million per day, quick full approval of mRNA vaccines, boosters, and vaccines available for kids “not beyond the fall.”
Dr. Anthony Fauci is the Chief Medical Adviser to President Joe Biden and Director of the National Institute of Allergy and Infectious Diseases (NIAID).
Chris Murray, IHME
Chris Murray, director of IHME, joined our podcast once again, at this major moment of reset of expectations – of our ability to control the pandemic, of policy decisions, data gaps, political attitudes and behavior, hitting the wall of hesitancy and refusal to vaccinate, and public confusion. We cover the full gamut: the forecast for the fall surge, missteps on masking, the need for greater transparency in data, and how much room exists to overcome resistance to vaccines.
Chris Murray is the Director of the Institute for Health Metrics and Evaluation, and Chair and Professor, Department of Health Metrics Sciences, at the University of Washington in Seattle.
Dr. Deborah Birx
Dr. Birx, former Response Coordinator during the Trump administration of the White House Covid-19 Task Force, served also as the Global AIDS Coordinator and Special Representative for Global Health Diplomacy between April 2014 and January 2021. She joined us for an extended conversation on the accelerating changes surrounding us – the Delta variant surge, new discoveries regarding breakthrough infections among the vaccinated, continued vaccine hesitancy, and refusal that has prompted the declaration of “a pandemic of the unvaccinated.” As we speak, newly revised policies on masks and vaccinations are getting unveiled. What to make of this new phase, and where is it heading? We’ll need far higher testing and genomic sequencing, intensified local engagement, a big push on accelerating therapies, and thinking ahead on what the future mix of vaccines will look like.
Dr. Deborah Birx is a Senior Fellow at the George W. Bush Presidential Center