Speaker 1: Hi everyone, I'm Katie Kuric, and welcome to next question. Today,
Speaker 1: we once again are dedicating our full attention to the
Speaker 1: coronavirus pandemic, which continues to spread across the country, growing
Speaker 1: at alarming rates in the most populated areas. In fact,
Speaker 1: on Friday, March, the Mayor of New York City, Bill
Speaker 1: de Blasio, marked a distressing new milestone. I hate to
Speaker 1: say this, but it's true. We are now the epicenter
Speaker 1: of this crisis. New York State has nearly half of
Speaker 1: the nation's coronavirus cases, and the number is growing faster
Speaker 1: than anyone predicted. As of this recording, the positive COVID
Speaker 1: nineteen count in New York City is doubling every three days.
Speaker 1: Here's Governor Andrew Cuomo. On March, one of the forecasters
Speaker 1: said to me, we were looking at a freight train
Speaker 1: coming across the country. We're now looking at a bullet train,
Speaker 1: because then numbers are going up that quickly. What that
Speaker 1: means is that the peak of coronavirus infections will be
Speaker 1: much higher and hit New York much sooner than expected.
Speaker 1: Giving the city's vast network of hospitals, which are already
Speaker 1: under tremendous strain, less time to prepare, less time to
Speaker 1: get the critical equipment they need to care for those patients,
Speaker 1: and less time to replenish their stash a protective gear
Speaker 1: so that medical staff can continue to work without getting sick,
Speaker 1: Which leads to my next question, how are emergency rooms
Speaker 1: in New York City faring now? And how are they
Speaker 1: bracing for what's to come? And later on what could
Speaker 1: have been done to allow us to be better prepared
Speaker 1: for this pandemic. But first, Hi, rob Hi, Hi, it's Katie.
Speaker 1: How are you? How are you doing? Oh? My god?
Speaker 1: Thank you for taking time to do. Dr Robert Semia
Speaker 1: is the Chair of Emergency Medicine IT and y you
Speaker 1: Land Gown in New York City. In that role, he's
Speaker 1: in charge of the emergency departments of several n y
Speaker 1: U hospitals across the metropolitan area. We see about five
Speaker 1: thousand patients in all of our emergency departments across Manhattan, Brooklyn,
Speaker 1: and Long Island, and we've seen a couple of consistent things.
Speaker 1: One Overall, at the majority of our emergency departments, the
Speaker 1: volume is down, but we have a huge spike in
Speaker 1: the number of respiratory cases that are serious requiring requiring intubation,
Speaker 1: and that numbers seems to be growing every day. I
Speaker 1: get a I get a report every twelve hours from
Speaker 1: our emergency departments Shift report one of our a d s. Yesterday,
Speaker 1: in a twelve hour period intubated seven patients had put
Speaker 1: them on ventilators. That's a huge number for one twelve
Speaker 1: hour period of time. And then you know we have
Speaker 1: very The next day might be one or two. The
Speaker 1: next day it might be six or seven again, so
Speaker 1: there's capacity right now, but everyone's trying to figure out
Speaker 1: how do you make sure that there's capacity down the road.
Speaker 1: To help with some of this, we stood up a
Speaker 1: twenty four hour a day video visit telemedicine, where now
Speaker 1: we're seeing a thousand visits on a telemedicine platform trying
Speaker 1: to keep people off the subways from spreading disease, giving
Speaker 1: them advice, and keeping them out of the emergency departments.
Speaker 1: So we have seen some good impact there where our
Speaker 1: overall eat volume is down for people that are not
Speaker 1: seriously ill, but we have seen a huge spike in
Speaker 1: the number of people who are very sick and needing
Speaker 1: to be put on ventilators. Well, let's first talk about
Speaker 1: the telemedicine patients rob you're seeing. Basically, they need to
Speaker 1: know if their symptoms are serious enough to go to
Speaker 1: the hospital, if they in fact have COVID nineteen. In
Speaker 1: most of those cases, are you able to encourage them
Speaker 1: to in fact stay at home and to self quarantine.
Speaker 1: We have. One of the things that the telemedicine visits
Speaker 1: that we're seeing is that there's a lot of public
Speaker 1: fear and it's grounded in in really a lack of information,
Speaker 1: and so we're seeing many patients who really have a
Speaker 1: couple of questions. One, they want to know if they're
Speaker 1: going to get seriously ill suddenly and die. Number two,
Speaker 1: they want to know if they need a test for COVID.
Speaker 1: And number three they want to know, Okay, what symptoms
Speaker 1: do I watch for if I quarantine at home. When
Speaker 1: someone calls you, particularly an elderly person, and worries that
Speaker 1: that person is going to be come extremely ill from this,
Speaker 1: what do you tell them? The majority of calls that
Speaker 1: we're seeing are from people that are younger that have
Speaker 1: symptoms that most of us, if it wasn't this pandemic,
Speaker 1: would think our typical winter rest the tory colts, low
Speaker 1: grade fever, cough um right, no sore throat. The issue
Speaker 1: is that those symptoms overlap with the same symptoms as
Speaker 1: COVID and UM. What I tell patients is that most
Speaker 1: of us will probably are many of us will probably
Speaker 1: get COVID and UM not even realize that. We'll just
Speaker 1: think at the winter cold and the majority of us
Speaker 1: will do just fine. UM. And really the people that
Speaker 1: need to go to the e r s are those
Speaker 1: who have those typical resttory symptoms and then those symptoms
Speaker 1: progress to UM shortness of breath and difficulty in breathing,
Speaker 1: and so we give them advice about that, and we
Speaker 1: also talk about the need for testing. And for most patients,
Speaker 1: what we tell them is, you know, if your symptoms
Speaker 1: are in that minimal group right now, you're not having
Speaker 1: shortness of breath. Whether you have a COVID test or not,
Speaker 1: does not change the information and the guidance that I'm
Speaker 1: going to give you right now, which is to stay
Speaker 1: at home self quarantine um UH. Go to the CDC
Speaker 1: or the government websites. UM. If you're unsure about the
Speaker 1: best way to self quarantine at home. We usually tell
Speaker 1: people you should do things like if you share a
Speaker 1: bedroom with someone, to sleep in a separate bedroom, if
Speaker 1: you have a second bathroom, try to use that bathroom,
Speaker 1: do good disinfection of counter surfaces, and those things. And
Speaker 1: then we give them guidance about what you need to
Speaker 1: watch for, and that being the increasing shortness of breath
Speaker 1: and for those patients, you should come to the emergency department.
Speaker 1: Most people are pretty relieved when they hear that because
Speaker 1: they're just not sure. The experience that we're seeing in
Speaker 1: the emergency department is that the majority of the patients
Speaker 1: that are ending up on rest but on ventilators are elderly,
Speaker 1: but we are seeing people in younger age groups that
Speaker 1: are very sick. Also. I'll tell you what's been the
Speaker 1: uplift thing part of these conversations is that we're seeing
Speaker 1: many people that are younger generations that are sick, and
Speaker 1: they're telling me, you know, I don't want to go
Speaker 1: out and potentially infect older people, and I don't want
Speaker 1: my grandmother and my grandparents to be at risk, and
Speaker 1: so um, that part has been very uplifting to to hear.
Speaker 1: So it's that's positive because we've seen so many stories
Speaker 1: rob of of kids going on spring break and being irresponsible.
Speaker 1: So it's nice to hear that younger people are actually
Speaker 1: thinking otherwise than trying to be more responsible. Let's talk
Speaker 1: about personal protective equipment or PPE, a word that the
Speaker 1: general population now understands that used to be the purview
Speaker 1: of the medical community. We're talking about the mass, the gowns,
Speaker 1: the gloves that protect you and your team from coronavirus. UM.
Speaker 1: Are you all getting the equipment you need? There's not
Speaker 1: enough and UM we have the equipment now, but we're
Speaker 1: worried that UM, as is everybody that will run out,
Speaker 1: and so we started conservation measures that are safe, but
Speaker 1: they're psychologically taxing on the doctors and nurses at work.
Speaker 1: So UM. Some of the things that we've done UM
Speaker 1: are to cohort any patient that comes into emergency departments
Speaker 1: into just one area of the e er. Whereas before
Speaker 1: all this happened, you you know, we have multiple teams
Speaker 1: and we have big emergency departments, and you could go
Speaker 1: to any part of the emergency department. Now we we
Speaker 1: put all the patients in one area that have those symptoms,
Speaker 1: and in that area are doctors and nurses where those
Speaker 1: and nine masks that you're probably hearing about and those
Speaker 1: masks are in short supply. And and how those masks
Speaker 1: help is they help with airborne or or virus that's
Speaker 1: floating in the air, and typically they're used for tuberculosis
Speaker 1: or things like that. COVID appears to be mostly droplets,
Speaker 1: so somebody sneezes on you, costs on you. Those that
Speaker 1: liquid hits you, um and doesn't really hang in the air,
Speaker 1: but there are some indications that for certain things it
Speaker 1: does hang in the air, like when we're doing an
Speaker 1: intubation or those things. So, UM, what we've had to
Speaker 1: do is to somewhat limit how many times we change
Speaker 1: out of that equipment, so you might wear your same
Speaker 1: mask with a face shield, for example, on the entire shift,
Speaker 1: instead of changing it multiple times to shift. We do
Speaker 1: change our gowns and other things. Or if we get sprayed,
Speaker 1: of course we change. But that's something that we never
Speaker 1: had to do. We never had to worry about conservation
Speaker 1: and UM, to an im introom doctor or nurse, it's
Speaker 1: it's an emotional drain. Um. You're already in a in
Speaker 1: a and basically a space suit that you can only
Speaker 1: change up part of it. You're hot, you're sweaty. Yeah,
Speaker 1: everybody's concerned that. You know, can the supply and chain
Speaker 1: catch ups? Anybody who works with you have any of
Speaker 1: your colleagues got sick? Yes, Um, so many of our
Speaker 1: people have gone sick. Doctors and nurses with fevers or costs.
Speaker 1: We they all get sent home. When COVID testing was available,
Speaker 1: they were tested, some of them positive, some negative. The
Speaker 1: good news is all of all of our people who
Speaker 1: actually have been positive and sick are all better and
Speaker 1: return to work. Now we've done some things. We do
Speaker 1: have some more senior physicians. We've kept them uh in
Speaker 1: parts of the emergency department where they're not exposed, you know,
Speaker 1: just knowing that that most people that have a little
Speaker 1: more candles on their birthday cake are more at risk.
Speaker 1: But no, the good news is is at n y
Speaker 1: U Land going here, every every one of our doctors
Speaker 1: and nurses that's gotten sick has recovered us fine. I
Speaker 1: want to bring up a question from a listener. Her
Speaker 1: name is Mary, she's a nurse. She doesn't say where
Speaker 1: she works, but she wondered if how care workers should
Speaker 1: isolate themselves from their families. I'm assuming even if they're
Speaker 1: asymptomatic if and if so, how have you gotten such
Speaker 1: a question yourself? What are you advising your colleagues to do? So?
Speaker 1: One of the things is that, UM, you know, just
Speaker 1: like the general public. UM. You know, our colleagues and
Speaker 1: the emergency departments UM here in New York and across
Speaker 1: the country come to work every day. But everybody has
Speaker 1: their own anxieties about this, and so for example, UM,
Speaker 1: we've created the ability for people to shower before they
Speaker 1: actually go home because they're wondering, am I going to
Speaker 1: spread something? Am I an asymptomatic career? I have people
Speaker 1: that I work with who have decided they have a
Speaker 1: little baby at home, and with their seeing they pan
Speaker 1: out there that they're not going to go home, They've
Speaker 1: got a friend's place to stay at, who has a
Speaker 1: vacant apartment, of those kind of things. All those questions
Speaker 1: we run we run by our infection disease specialists. But
Speaker 1: I think you know a lot of people, even when
Speaker 1: they're doing the best practices at home, whether that's trying
Speaker 1: to keep a distance, even though they may not have
Speaker 1: any UM symptoms, they're still wondering. They're still worried for
Speaker 1: themselves and their word, for their family, and so they're
Speaker 1: taking whether it's appropriate, precautions, extra precautions. Yeah, people worry
Speaker 1: about those things and they try to keep some distance. UM.
Speaker 1: When I do these videos is it's also sides working
Speaker 1: in the dy we do get people. Another group that
Speaker 1: we're concerned about is if you live with somebody who's
Speaker 1: immuno compromised. You know, I've had people tell, you know,
Speaker 1: talk to me saying, you know, they can't get COVID
Speaker 1: testing as of today. Um. That seems to be constantly
Speaker 1: changing the availability of public testing. They're concerned because someone
Speaker 1: they live with has multiple miloma or some form of cancer.
Speaker 1: They're aware that those people are at an increase risk,
Speaker 1: and so they want to do the right thing. Try
Speaker 1: to keep their distance, try to socially isolate, but try
Speaker 1: to do that while you're sharing a home with somebody.
Speaker 1: I had people tell me they're living in their basement
Speaker 1: if they have a basement. Um. So there's a lot
Speaker 1: going on, um as people try to keep each other
Speaker 1: as safe as possible. When you think about the next
Speaker 1: few weeks, do you have any idea when this is
Speaker 1: going to peak? No idea, I don't you know, I
Speaker 1: don't know. UM, you know, it's hard hard to say, UM,
Speaker 1: I'm seeing sicker patients and in increasing numbers. I don't
Speaker 1: know when that will level off. Our general approach is
Speaker 1: that we need to be prepared for this to be
Speaker 1: a marathon and not a sprint, and so making sure
Speaker 1: that our doctors and nurses get adequate respite, making sure
Speaker 1: that we have relief physicians and nurses available should it,
Speaker 1: should much of the workforce go down temporarily or have
Speaker 1: to go home because they're sick. For approaches, UM do
Speaker 1: our best on a day to day basis, but our
Speaker 1: eyes looking down the road always tell people that you know,
Speaker 1: working in an emergency department on a regular day is
Speaker 1: like running a two minute no huddle offense in football,
Speaker 1: but for eight hours. And now you throw in, UM,
Speaker 1: some uncertainty into that mix. It's it's like you're trying
Speaker 1: to do that in a swimming pool. But UM, people
Speaker 1: that work in emergency departments are special. They have big hearts,
Speaker 1: They feel for patients and human suffering, and UM are
Speaker 1: really up for this challenge and and just want to know.
Speaker 1: I just want to feel that their support for them,
Speaker 1: and that support looks like proper ppe and UM, I
Speaker 1: will tell you that doing some of these videos. Its
Speaker 1: also has been uplifting because so many times people have
Speaker 1: expressed gratitude for what e R doctors and nurses do.
Speaker 1: We're getting more thank you than we normally do. We're
Speaker 1: seeing young people talk about how they're worried about older folks,
Speaker 1: and there's this multigenerational kind of commitment and kindness and
Speaker 1: empathy that's on display. So, UM, yeah, you know, we're
Speaker 1: all as a nation going through a lot, and we're
Speaker 1: all in this together. But I've seen some really encouraging
Speaker 1: signs of um, what the future looks like and um
Speaker 1: seeing a lot of people's in her kindness right to
Speaker 1: the surface, and that makes me feel really good. That
Speaker 1: was Dr Robert Famiett, Chair of Emergency Medicine at and
Speaker 1: why you land gone in New York City and why
Speaker 1: you may be managing now, but other hospitals around New
Speaker 1: York City and indeed the country are already struggling under
Speaker 1: the pressure of the coronavirus and the weeks to come.
Speaker 1: I'll be continuing to reach out to those working on
Speaker 1: the front lines of this pandemic, and I'll bring you
Speaker 1: those stories here on this podcast, also on Instagram. Live,
Speaker 1: which you can find by searching my name Katie Curic
Speaker 1: on Instagram. Up next, why wasn't this country better prepared?
Speaker 1: We'll talk with an expert whose job was to do
Speaker 1: just that. Welcome back, everyone. We're continuing our coverage of
Speaker 1: the coronavirus this week, taking a look at pandemic preparedness
Speaker 1: from the emergency room to the oval office. Hi, fa Hi,
Speaker 1: thanks so much for doing this. Beth Cameron is the
Speaker 1: former Senior Director for Global Health Security and Bio Defense.
Speaker 1: This unit, which was a part of the White House
Speaker 1: National Security Council, was established by the Obama administration after
Speaker 1: the two thousand fourteen Ebola epidemic, and it was intended
Speaker 1: to be a smoke alarm, a warning of the first
Speaker 1: signs of a global health crisis. In two thousand eighteen, however,
Speaker 1: the Trump administration disbanded the unit. The Office of Global
Speaker 1: Health Security and Bio Defense was set up after the
Speaker 1: Ebola epidemic in order to get ahead of outbreaks before
Speaker 1: they become epidemics or pandemics. We're really worried coming out
Speaker 1: of Ebola. It was a hugely devastating outbreak that killed
Speaker 1: over eleven thousand people. UM, but we were looking at
Speaker 1: that as ultimately an event that stayed relatively circumscribed to
Speaker 1: three major countries. Of course, there were lots of concerns
Speaker 1: that it would spread more rapidly, and there was a
Speaker 1: huge global intervention that the US helped lead to keep
Speaker 1: that from happening. But we were very worried about exactly
Speaker 1: what we're seeing now, a large scale respiratory illness that
Speaker 1: would become a pandemic, and we knew that we weren't
Speaker 1: prepared for that as a nation or as a world.
Speaker 1: Let's imagine a world in which that office had not
Speaker 1: been dissolved and you were still leading at Beath. What
Speaker 1: role would it be playing right now in the midst
Speaker 1: of this crisis. It would really be the best way
Speaker 1: to describe the office's role now would be as a
Speaker 1: coordinating hub. So the office was playing a role in
Speaker 1: in working with high level senior officials and sending information
Speaker 1: about problems and issues up the chain so that they
Speaker 1: would be resolved quickly. But also really importantly, we're listening
Speaker 1: to staff at the working level across departments and agencies.
Speaker 1: So when there was a problem or a challenge or
Speaker 1: a need in the States or in another country. We
Speaker 1: were able to figure out, Hey, what's the real issue,
Speaker 1: who's not agreeing, and then elevate it really quickly. You
Speaker 1: helped transition the incoming Trump administration. You directly briefed then
Speaker 1: Homeless Security Advisor Tom Bossard. Did you have a sense
Speaker 1: at that time the new administration was committed to the
Speaker 1: objectives of this office. Yes, during the transition, I had
Speaker 1: quite a good experience with transitioning this specific office from
Speaker 1: President Obama to President Trump, and both the outgoing team
Speaker 1: and the incoming team, particularly as you mentioned, Homeland Security
Speaker 1: Advisor Tom Basser had been through um pandemic threats before
Speaker 1: in the Bush administration, and so there's actually quite a
Speaker 1: lot of support for continuing the role of this office,
Speaker 1: and not only from Tom Basser, but also from National
Speaker 1: Security Advisor HR McMaster, who I briefed before I left.
Speaker 1: You said you were mystified when the Trump administration dissolved
Speaker 1: the office in May of two thousand eighteen. Now there
Speaker 1: seems to be a difference of opinion here with your
Speaker 1: op ed in the Washington Post and someone within the
Speaker 1: Trump administration name Tim Morrison, who believes that your account
Speaker 1: was wrong. So tell me as you understand it. What happened?
Speaker 1: Can you explain? I can, and and I think that
Speaker 1: Tim's op ed was less of a rebuttal of what
Speaker 1: I said and more of an explanation of the organizational
Speaker 1: structure UM and what happened. So my understanding of what
Speaker 1: happened is that Tim Zeemer, who took my position as
Speaker 1: the head of the Office UM, left the White House
Speaker 1: and the people who worked on his team were dissolved
Speaker 1: and were moved into another director at the director that
Speaker 1: Tim Morrison ran. And it's definitely true that some good
Speaker 1: policies did come out of that office following the dissolution
Speaker 1: of the pandemics team. But the difference, the critical difference,
Speaker 1: is that there wasn't a team or a senior level
Speaker 1: person whose only responsibility it was to handle pandemic threats.
Speaker 1: And that was something that coming out of the BOWLA
Speaker 1: Epidemic re realized was missing. That we were all focused
Speaker 1: on epidemic, we were all focused on the BOWLA outbreak,
Speaker 1: but we didn't have a singular mission with a direct
Speaker 1: reporting line to the National and Homeland Security Advisor where
Speaker 1: our job was only to focus on that issue. And
Speaker 1: it's like a transnational threat like counter terrorism um, like
Speaker 1: climate change, it's something that when we see what's happening now,
Speaker 1: it's easy to understand why you'd want to have a
Speaker 1: singularly focused pandemics team. But when you don't have a
Speaker 1: pandemic happening, I can see how it would how a
Speaker 1: national security advisor might look at that and think, well,
Speaker 1: maybe we don't need a team that's solely focused on
Speaker 1: this issue, and I just completely disagree with that. This
Speaker 1: is a lesson that lots of administrations have learned. So
Speaker 1: there have been senior level officials in the last couple
Speaker 1: of administrations focused on pandemic threats, and usually it's after
Speaker 1: an outbreak or a pandemic when that lesson um is learned.
Speaker 1: And so one of the things that happened in the
Speaker 1: Obama administration is a couple of lessons came together. One
Speaker 1: of those lessons was that we needed a senior level
Speaker 1: official who's only job it was with a direct reporting
Speaker 1: line to leadership. The other lesson is that we needed
Speaker 1: a team that looked at homeland and national security issues together.
Speaker 1: When President Trump was asked about this Beth during one
Speaker 1: of the White House press conferences, he insisted he didn't
Speaker 1: know anything about that, But you did disband the White
Speaker 1: House Pandemic Office, and the officials that were working in
Speaker 1: that office left this administration abruptly, So what responsibility do
Speaker 1: you take to that? And the officials that worked in
Speaker 1: that office said that you that the White House lost
Speaker 1: valuable time because that office wasn't disbanded. What do you
Speaker 1: make of that? Well, I just think it's a nasty
Speaker 1: question we've done. Were you surprised at that and who
Speaker 1: exactly was in charge of getting rid of the position?
Speaker 1: I was surprised by that. Um. I was surprised because
Speaker 1: there was quite a lot of press about getting rid
Speaker 1: of the office in when it happened, and there were,
Speaker 1: you know, a number of high level people in Congress,
Speaker 1: UM think tanks who wrote letters or spoke out and
Speaker 1: said that this was a mistake. So I was surprised
Speaker 1: that he wasn't aware. Um. The all I can say
Speaker 1: is that the dissolution of the office happened around the
Speaker 1: same time that Tom Bosser left, so right after he
Speaker 1: left and right as National Security Advisor John Bolton came
Speaker 1: on board, and so I think this really was part
Speaker 1: of an overall restructuring and a decision was made that
Speaker 1: this reorganization was a was a better organization for the
Speaker 1: White House. The White House is to choose its organizational structure.
Speaker 1: But it's unfortunate that this lesson got unlearned in the process.
Speaker 1: Let's talk about some of the warning signs though, that
Speaker 1: existed for this current epidemic pandemic. Rather, can you talk
Speaker 1: about some of the flashing red lights that we saw
Speaker 1: because there were a number of them, weren't there. Yeah,
Speaker 1: there were a number of them. Um, you know, going
Speaker 1: back to the beginning and watching the outbreak unfold in China,
Speaker 1: looking at a novel coronavirus that had um the ability
Speaker 1: to spread between people. That was definitely something in our
Speaker 1: playbook of concerns, you know, a new disease that could
Speaker 1: spread more quickly between people with with a higher mortality.
Speaker 1: And I think the second that that information became available,
Speaker 1: that would have flipped a switch for us to start
Speaker 1: meeting more regularly and thinking about what kinds of what
Speaker 1: kinds of preparedness plans we needed to put in place
Speaker 1: or dust off in the United States. And when was that?
Speaker 1: That was in January when those cases really started coming
Speaker 1: coming to light. There was absolutely a bit of a
Speaker 1: delay in the world learning about this, But we did
Speaker 1: learn about it um in January, UM, several months ago.
Speaker 1: I want to mention something even prior to that. According
Speaker 1: to The New York Times, there was a training exercise
Speaker 1: led by multiple federal agencies, twelve states, and private stakeholders
Speaker 1: that simulated a scenario where respiratory virus dubbed the crimson
Speaker 1: can tajun rapidly spread through the United States. What can
Speaker 1: you tell us about that, because before we talk about
Speaker 1: January February, let's talk about October. Yeah, well, we can
Speaker 1: go back even further than than October. We can go
Speaker 1: back to the transition between the administrations. So back in January,
Speaker 1: before the Obama administration left, there was a half day
Speaker 1: um discussion between the outgoing cabinet, the outgoing White House leadership,
Speaker 1: and the incoming team, the presumptive nominees for the Trump administration,
Speaker 1: And we looked at a number of homeland threats and
Speaker 1: one of the small number of things highlighted for the
Speaker 1: incoming team was pandemic was pandemics. So I was in
Speaker 1: that discussion and helped put that that discussion together, and
Speaker 1: there was a very robust conversation between outgoing officials and
Speaker 1: incoming officials about a respiratory agent um in that place,
Speaker 1: I think we were looking at a flu variant that
Speaker 1: could do something very similar to what's happening now. And
Speaker 1: then fast forward to a number of tabletops that happened
Speaker 1: outside of government, as well as the one highlighted in
Speaker 1: the New York Times, which actually I was not aware
Speaker 1: of that exercise and wasn't in government when it was conducted,
Speaker 1: but reading the reports of it, it looks eerily similar
Speaker 1: to what's happening now and certainly is something that White
Speaker 1: House leadership should and would have been aware of. So
Speaker 1: why do you think they didn't pay attention to that?
Speaker 1: I mean, the serendipity of that simulation is pretty uncanny.
Speaker 1: I think a couple of things, just having gone through
Speaker 1: these exercises, they can they can based on who's in
Speaker 1: charge of of acting on what comes out. They either
Speaker 1: become playbooks for action and urgent action, or they become
Speaker 1: overwhelming and people don't know where to start to fill.
Speaker 1: What is apparent now to us in the world is
Speaker 1: just a massive, massive set of gaps in pandemic preparedness.
Speaker 1: So um, all I can say is that this was this,
Speaker 1: this issue of pandemic preparedness should be funded the way
Speaker 1: that we fund military defense. It needs to be UM,
Speaker 1: it needs to be completely ramped up. It needs to
Speaker 1: include um A massive lessons learned. When this is all
Speaker 1: over and I think UM moreover, it's it's inexplicable to
Speaker 1: me why we haven't been able to act on some
Speaker 1: of the major recommendations that have come out of out
Speaker 1: of exercises throughout the last several months and years. So
Speaker 1: when you dig deep and try to understand it, what
Speaker 1: conclusions do you draw? I draw a couple m One
Speaker 1: is that it's really hard to imagine a scenario on
Speaker 1: the scale of what's happening now, and so we've developed
Speaker 1: many tools over the last couple of decades to help
Speaker 1: us with pandemic threats. One is our Strategic National Stockpile,
Speaker 1: which has been in the news a lot lately. Another
Speaker 1: is the Global Health Security Agenda, which is something the
Speaker 1: Obama administration launched to assist other countries to get prepared.
Speaker 1: Both of those efforts, just as in another is our
Speaker 1: Biomedical Research and Development Agency bar TO, which helps advance
Speaker 1: medical countermeasures. These are massive efforts that different presidents launched
Speaker 1: which when we look at them in retrospect, made a
Speaker 1: huge difference in our ability to deal with this crisis,
Speaker 1: but didn't go nearly far enough. And so I think
Speaker 1: part of it is when you look at the reports
Speaker 1: written about nine eleven, it's a failure of imagination, not
Speaker 1: to imagine what could happen, we're pretty good at that
Speaker 1: and tabletop exercises, but to actually get past the imagining
Speaker 1: and into the filling of the major gaps that will
Speaker 1: have to deal with in the worst case scenario. And
Speaker 1: I think that's been challenging for for many leaders to
Speaker 1: wrap their heads around, including me when I was in government.
Speaker 1: But I also think that it's a it's a failure
Speaker 1: of of not having enough people in government whose day
Speaker 1: to day job it is to be thinking about those gaps.
Speaker 1: I put out a note to doctors, ner, his respiratory therapist, etcetera,
Speaker 1: to tell me about what they were experiencing, and it's heartbreaking.
Speaker 1: I just got a message this morning from someone who
Speaker 1: is a doctor in Louisiana who's already lost several colleagues
Speaker 1: to the coronavirus. Who can who's writing her will? I mean,
Speaker 1: it's just heartbreaking to me. These young people who are
Speaker 1: working so hard on the front lines. And I don't
Speaker 1: want this to be a Kulda would have should have,
Speaker 1: But there has to be some lessons learned. I hope
Speaker 1: there's a commission similar to the nine eleven commission to
Speaker 1: look back on this. But what could have been done
Speaker 1: to provide to our most critically important healthcare professionals the
Speaker 1: protective equipment they needed? How could we have supported these
Speaker 1: people more and protected them? I think it's a It's
Speaker 1: an excellent question, the hardest question to answer. I think
Speaker 1: right now, UM, it's very clear that we needed a
Speaker 1: much more nationalized response than we currently have. And UM,
Speaker 1: I think going back a couple of months, we should
Speaker 1: have been thinking forward about that nationalized response. So what
Speaker 1: I mean by that is, right now, we're seeing reports
Speaker 1: and I'm hearing them to talking to mayor's offices and
Speaker 1: people who are out on the front lines in the field,
Speaker 1: and they're cannibalizing each other. They're trying to buy equipment,
Speaker 1: um over top of each other. And the problem is
Speaker 1: that we have a system in the United States for
Speaker 1: responding to a pandemic that is built on what the
Speaker 1: states will request, and that that's still the system that
Speaker 1: the federal government seems to be building its response off of.
Speaker 1: And this isn't a hurricane. Hurricanes are hugely devastating, but
Speaker 1: they usually don't affect all fifty states at once, and
Speaker 1: usually they don't continue for months and months and months UM.
Speaker 1: And so our system is built for providing and scaling
Speaker 1: up specific commodities and then getting them out quickly to
Speaker 1: the field, but not ramping up production continually for all
Speaker 1: fifty states. And so it's really it's clear to me,
Speaker 1: at least at this moment, that we need someone in
Speaker 1: charge of the National Logistics Response UM, working with FEMA
Speaker 1: or maybe from within FEMA, but planning this the way
Speaker 1: we do a massive military operation. I don't mean to
Speaker 1: militarize the response in that sense, but using those tools
Speaker 1: that we have to transport, produce, and supply our country.
Speaker 1: And it doesn't seem like we've kicked that into high gear,
Speaker 1: nor that we were planning to do that a couple
Speaker 1: of months ago, when it would have made a much
Speaker 1: bigger impact. So what's the solution now? I mean, these
Speaker 1: people are desperate, they're reusing these and mass they're trying
Speaker 1: to sanitize them. They don't have the equipment they need.
Speaker 1: How the heck do we get this equipment to these
Speaker 1: people pronto? So I see two solutions and two and
Speaker 1: neither of them are perfect and neither of them are
Speaker 1: fast enough. But solution number one is that we UM,
Speaker 1: we have a national registry that starts monitoring where all
Speaker 1: the pp is and brings together all of these great
Speaker 1: um blooming initiatives that are happening out in the field
Speaker 1: under an umbrella that can actually match make much more
Speaker 1: effectively between states and entities that need personal protective equipment
Speaker 1: and other supplies the most. And that would require a
Speaker 1: real nationalized response with the logistics plan and someone in
Speaker 1: charge of it who knows how to plan, you know,
Speaker 1: on the order of a military operation, somebody like the
Speaker 1: head of trans Calm who does this for a living.
Speaker 1: When we UM, when we have a massive operation overseas.
Speaker 1: The other option, UM, if that can't happen, or won't happen,
Speaker 1: or isn't agreed to happen, is that the governors could
Speaker 1: UM come together and decide to do this themselves. UM.
Speaker 1: They could work with UM a coordinator on their own.
Speaker 1: They could work with the private sector with Amazon and
Speaker 1: you know ups and others who have logistics chains themselves
Speaker 1: to create a more nationalized system across the fifty States.
Speaker 1: UM and I I've talked to a few people about
Speaker 1: that idea, almost an air traffic controller concept for the
Speaker 1: for the response, and I think that it's something that
Speaker 1: could work, but it would really need the right person
Speaker 1: in agreement from the States to do it. The other
Speaker 1: thing that really makes me frustrated right now looking at
Speaker 1: the response is that ideally, UM, what we do, what
Speaker 1: the United States of America does, is we lead the
Speaker 1: global response, and we're not right now, and we should
Speaker 1: be making enough to staff and stock our own country,
Speaker 1: and then we should be shipping it and coordinating the
Speaker 1: response all over the world. And right now we're one
Speaker 1: of the only countries in the world that can actually
Speaker 1: do that, even though it's hard to see that we
Speaker 1: can at this moment, we have the capability, the logistics capability,
Speaker 1: of production and manufacturing capability to do that, and we're not.
Speaker 1: We should make too many and then we should staff
Speaker 1: the global response. We'll return with Beth Cameron after the
Speaker 1: short break. We're back with Beth Cameron, who ran the
Speaker 1: White House Pandemic Office from two thousand sixteen until March
Speaker 1: of two thousand seventeen. A year later, the Trump administration
Speaker 1: disbanded the office, a move that she says left the
Speaker 1: country less prepared for pandemics like COVID nineteen. What about
Speaker 1: these tests, um and the CDC? I mean, did the
Speaker 1: CDC just royally screw up? I hate to be so
Speaker 1: blunt about this, but did the CDC all down on
Speaker 1: the job? What happened with these this whole testing thing?
Speaker 1: Why weren't there enough? And why are there still not enough?
Speaker 1: I think there are a couple of failures on the
Speaker 1: testing front um, and I've done some forensics on this, um,
Speaker 1: there are other people that have to I actually lay
Speaker 1: the criticism for this not directly at CDC s feed,
Speaker 1: although certainly there were some challenges at CDC in this
Speaker 1: as well. I lay it at the feet of leadership
Speaker 1: because honestly, UM, when CDC realized that their test kit
Speaker 1: was going to have problems, M yes, someone should have
Speaker 1: sent a flare up saying, hey, we have problems, let's
Speaker 1: have a backup, let's order the w h O kits,
Speaker 1: let's put them through emergency use authorization so we can
Speaker 1: do that. But somebody else at HHS in the government
Speaker 1: at the White House, UM, in leadership position should have said, look,
Speaker 1: while you're working on this test and perfecting it, we
Speaker 1: are going to create a backup because it is too
Speaker 1: important that we start testing now. Um. That's not necessarily
Speaker 1: the job of the people manufacturing the test kit at CDC.
Speaker 1: It's their job to alert, but it's somebody else's job
Speaker 1: to say, Okay, we're going to make the decision for
Speaker 1: you that this isn't the only test that we're going
Speaker 1: to have. And that's the kind of decision that the President,
Speaker 1: the Vice President, you know, the lead for this UH
Speaker 1: for this pandemic in the White House should be bugging
Speaker 1: every day about so. And to go full circle bath,
Speaker 1: that's the kind of issue this Pandemic Commission would have
Speaker 1: been all over and on top of, because it would
Speaker 1: have been part of its centralized role to make sure
Speaker 1: that you know, these things were taken care of in
Speaker 1: a in a very efficient, fast way. That's that was
Speaker 1: exactly the reason that the office was created to be
Speaker 1: able to get above the day to day challenges that
Speaker 1: people were facing, which are sometimes really hard to surface.
Speaker 1: As you know, when there's a problem, it's really hard
Speaker 1: for people at the working level to admit that the
Speaker 1: problem is great, especially if it's a problem that they
Speaker 1: don't usually experience. CDC is usually quite good at creating
Speaker 1: excellent test kits um and diagnostics. When they have a problem,
Speaker 1: somebody should say, look, you're having a problem. That's okay,
Speaker 1: We're going to help you solve the problem. But we
Speaker 1: can't wait for you. Um. That's that's leadership's job. And finally, Beth,
Speaker 1: there's been some rumblings and indication that the administration is
Speaker 1: weighing the cost on the economy with the cost on
Speaker 1: public health and and and human life. Really uh, that
Speaker 1: there's some drive in the White House, ostensibly led by
Speaker 1: the President himself, to try to take a look a
Speaker 1: couple of weeks to returning or making efforts to loosen
Speaker 1: the guidelines and mandates and to get the economy going again.
Speaker 1: So I think Easter Sunday and you'll have packed churches
Speaker 1: all over a country. I think it would be a
Speaker 1: beautiful time. And it's just about the timeline that I
Speaker 1: think is right. This is against the advice of I
Speaker 1: think universal advice of public health advocates and officials and experts. Um,
Speaker 1: can you weigh in on the rumplings we're hearing about that.
Speaker 1: I don't even think it's just the public health experts.
Speaker 1: I think it's every credible person that I've talked to. UM,
Speaker 1: we can't relax these measures, and it would be bad
Speaker 1: actually for the economy. I mean, if we weren't even
Speaker 1: thinking about the huge toll on lives and the at
Speaker 1: risk and the elderly, if we even put that aside
Speaker 1: for a second, this would be bad for the economy
Speaker 1: because until the case load comes down, until our hospitals
Speaker 1: system stabilizes, until we have a steady supply chain for
Speaker 1: all of the things we've been talking about, personal protective equipment,
Speaker 1: UM and re agents, test kits, etcetera. Until all of
Speaker 1: those things get to a stable level. If we turn
Speaker 1: people back on and send them back to work, where
Speaker 1: we'll see increasing spikes crashing health care system, people will
Speaker 1: then not go to work, or they'll be sick, they'll
Speaker 1: be confusion, and ultimately the economy will tank again. And
Speaker 1: it might even be it might I'm not an economist,
Speaker 1: but I surmise it might be worse because it will
Speaker 1: be even more unpredictable how that will happen across the country.
Speaker 1: So I think it would be a terrible idea to
Speaker 1: relax these measures right now when they're actually starting to
Speaker 1: make a difference. There does need to be hope, though, um,
Speaker 1: for the American public and for the economy. And I
Speaker 1: think that hope is letting the social distancing do its job,
Speaker 1: watching the case counts start to fall the way that
Speaker 1: they've fallen in other countries that have done this, and
Speaker 1: then ma of testing so that we know who is
Speaker 1: infected and ultimately also who has been infected, so that
Speaker 1: people can be isolated on a case by case basis,
Speaker 1: and the people that don't have the disease or who
Speaker 1: have recovered from it can start getting back to work.
Speaker 1: And I think that's what we have to be looking for,
Speaker 1: and we have to have um specific fact based measures
Speaker 1: that drive us in that direction. But we're definitely not
Speaker 1: there yet. It's fascinating to the science of this virus
Speaker 1: is so complex, um, And are you optimistic that that
Speaker 1: the scientists studying this, that that are working so hard
Speaker 1: on developing a vaccine, who are trying to identify the
Speaker 1: antibodies that some people have naturally to this virus, that
Speaker 1: that science will come up with some answers relatively soon.
Speaker 1: I'm optimistic, um, for sure that we're going to get there.
Speaker 1: I think most of the experts I trust, including folks
Speaker 1: that are out at the Coalition for Epidemic Preparedness Innovation,
Speaker 1: which has been looking at coronaviruses and vaccine candidates for
Speaker 1: coronaviruses for a while now. I'm optimistic that will eventually
Speaker 1: get a vaccine, but it will probably be twelve to
Speaker 1: eighteen months. I am optimistic that will eventually get to
Speaker 1: some therapeutics that might work for some individuals, and hopefully
Speaker 1: we'll get to some therapeutics that work for the elderly
Speaker 1: and for other at risk populations, because that's where if
Speaker 1: we can if we can help identify a few things
Speaker 1: that work, um, that would be even just to make
Speaker 1: it less less deadly, even if it's still has a
Speaker 1: terrible course in some people. UM, I think that would
Speaker 1: be helpful. I am optimistic, um, but I think we're
Speaker 1: in this for for months um until that point, and
Speaker 1: certainly at least a year for a vaccine. Well. Hopefully
Speaker 1: this terrible chapter in our history and and the world's
Speaker 1: history will provide some lessons learned. I have to believe
Speaker 1: that we will look back and try to get a
Speaker 1: handle on how we prevent this from happening in the future.
Speaker 1: That was Beth Cameron, currently the Vice president for Global
Speaker 1: Biological Policy and Programs at the Nuclear Threat Initiative. And
Speaker 1: that does it for this episode of Next Question. I
Speaker 1: know a lot of this can be tough to hear.
Speaker 1: These are indeed scary times, but if we do our part,
Speaker 1: if we heed the experts warnings and stay home and
Speaker 1: find virtual ways to connect, we can get through this.
Speaker 1: In the meantime, to lighten the load, I'd like to
Speaker 1: highlight an act of kindness. You might remember last week
Speaker 1: I asked you to share the good deeds you've seen
Speaker 1: or experienced during these dark times, and we've gotten some
Speaker 1: really touching ones. I'd like to share one message I
Speaker 1: received from a listener named Lee Stewart, who lives in Bristol, Virginia.
Speaker 1: A couple of days ago, my brother and I had
Speaker 1: to leave our eighty nine year old mother alone in
Speaker 1: the I see you of the local hospital because it
Speaker 1: had to ban visitation due to the coronavirus. Of course,
Speaker 1: we totally agree with the precautions, and even she understood
Speaker 1: that they were necessary. But it's so difficult, especially when
Speaker 1: right before I left, she clasped my hand and said,
Speaker 1: I don't want you to leave me. However, her nurses
Speaker 1: have been absolute angels. They have adopted her and even
Speaker 1: fixed the face time on her phone so that my
Speaker 1: brother and I can chat with her. So every afternoon
Speaker 1: one of the nurses holds up the phone own and
Speaker 1: calls us and we're able to have a nice long
Speaker 1: talk with our mom and just really see how she's doing,
Speaker 1: and she can see us. That gives her a lot
Speaker 1: of comfort. Um, we can't even describe how grateful we
Speaker 1: are for these medical professionals who are not only using
Speaker 1: their medical knowledge on the front lines of this crisis,
Speaker 1: but who also are providing a conduit of compassion that
Speaker 1: enables families like ours to stay together, even though it
Speaker 1: times that's only in a virtual way. Thanks for your
Speaker 1: hard work and inspiration during this crisis, and thanks so
Speaker 1: much to the our ends and other medical staff who
Speaker 1: are both warriors and angels during this time. Thank you, Lee.
Speaker 1: We wish you and your family well, and of course
Speaker 1: the same to all of our listeners. You can keep
Speaker 1: sending your moments of kindness. I think we could all
Speaker 1: use a dose of the fields. Just leave your name
Speaker 1: and a detailed message at eight four four four seven
Speaker 1: nine seven eight eight three again eight four four four
Speaker 1: seven nine seven eight eight three. You can also email
Speaker 1: me at info at Katie Kirk dot com. Just put
Speaker 1: kindness in the headline. For the most up to date
Speaker 1: information and guidance on the coronavirus pandemic, please visit the
Speaker 1: CDC and the World Health Organization. You can also check
Speaker 1: out our morning newsletter, wake Up Call. You can subscribe
Speaker 1: to that and get everything you need to know every
Speaker 1: morning in your inbox. Just go to Katie Kurk dot com.
Speaker 1: We'll be continuing this special coronavirus coverage on Next Question
Speaker 1: Him for the weeks to come. You can subscribe to
Speaker 1: us on Apple podcast, the I Heart Radio app, or
Speaker 1: wherever you listen to your favorite shows. Until next time
Speaker 1: and my Next Question, I'm Katie Couric. Thank you so
Speaker 1: much for listening, and stay safe everyone. Next Question with
Speaker 1: Katie Couric is a production of I Heart Radio and
Speaker 1: Katie Currik Media. The executive producers are Katie Kurik, Courtney Litz,
Speaker 1: and Tyler Klang. The supervising producer is Lauren Hansen. Our
Speaker 1: show producer is Bethan Macaluso. The associate producers are Emily
Speaker 1: Pinto and Derek Clemens. Editing by Derrek Clements, Dylan Fagan
Speaker 1: and Lowell Berlante, Mixing by Dylan Fagan. Our researcher is
Speaker 1: Gabriel Loser. For more information on today's episode, go to
Speaker 1: Katie Currek dot com and follow us on Twitter and
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