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Speaker 2: Geopolitics and the world at large certainly a focal point
Speaker 2: for US makes sense with the You and General Assembly
Speaker 2: underway here in New York City. We did have some
Speaker 2: comments from President Donald Trump out on his social media
Speaker 2: platform saying, I think Ukraine, with the support of the
Speaker 2: European Union, is in a position to fight and win
Speaker 2: all of Ukraine back in its original form. This is
Speaker 2: coming after President Trump and Ukrainian President Voldemir Zelensky met
Speaker 2: on the sidelines of the You and General Assembly earlier Tuesday.
Speaker 2: Earlier today, let's see what Michelle jem Risco has to say.
Speaker 2: She's Bloomberg White House, a national security editor. She's out
Speaker 2: there in our DC News bureau. Michelle, when it comes
Speaker 2: to the relationship with the US in Ukraine, it goes
Speaker 2: back and forth here.
Speaker 3: What's the read on this?
Speaker 4: Yeah, well, certainly goes back and forth, and as we
Speaker 4: all know, the president does like to be unpredictable. He
Speaker 4: likes to kind of maintain leverage and you know, upskating
Speaker 4: what his thinking might be and what his actions might be.
Speaker 4: And so while this is pretty jolting and a one
Speaker 4: to eighty turnabout really in terms of his comments around
Speaker 4: who is best position to win this war is kind
Speaker 4: of a part and parcel of what we see from
Speaker 4: from Trump and his sort of transactional diplomacy and his
Speaker 4: unpredictable diplomacy at that.
Speaker 5: So, yeah, my jaw dropped when I saw this. Carol
Speaker 5: can attest it because you know, for months we've been
Speaker 5: hearing about the idea that, yes, this war could end.
Speaker 5: This is coming from the president. This war could end
Speaker 5: if Ukraine seeds some territory and we took that to
Speaker 5: be to be land here. So this would seem like
Speaker 5: a direct one point eighty How does this happen? Or
Speaker 5: let me rephrase the question, Michelle, can this happen without
Speaker 5: us support?
Speaker 4: Well, that's certainly a high bar. I mean, I think
Speaker 4: we need to also look at this through the lens
Speaker 4: of what Trump is trying to achieve here. I mean,
Speaker 4: obviously he's been expressing disappointment as recently as this morning
Speaker 4: and as you and General Assembly a speech about Putin's behavior,
Speaker 4: the Russian prison's behavior as opposed to what his Trump's
Speaker 4: expectations were coming into office, as he admits he thought
Speaker 4: this would be one of the easier conflicts to resolve
Speaker 4: based on his relationship with Putin. That has not turned
Speaker 4: out to be the case, and it's frustrating the US
Speaker 4: president to the point of him kind of turning his
Speaker 4: strategy on its head and now speaking as if Ukraine
Speaker 4: has the upper hand in the war. So certainly some
Speaker 4: strategy in that respect. But to your point, yeah, it
Speaker 4: would be very tough, I think, to have this achieved
Speaker 4: without the support of the direct support of the US.
Speaker 4: But that is what Trump is willing to offer at
Speaker 4: this point. He's saying the US was willing to continue
Speaker 4: to support NATO to give the European allies the resources
Speaker 4: that they need to pass on to Ukraine, but it
Speaker 4: is loathed to get involved. And of course in successive administrations,
Speaker 4: the US has been loads to get involved with boots
Speaker 4: on the ground to help out as.
Speaker 2: Well, and the President did say, you believe NATO nations
Speaker 2: should shoot down Russian aircraft that violated their airspace, said
Speaker 2: the US would continue to supply, as you said, the
Speaker 2: alliance with weapons. This was happening as he met with
Speaker 2: the Ukrainian President Zelenski following recent incursions that have certainly
Speaker 2: alarmed allies when it comes to drones. He said, yes,
Speaker 2: I do, the President said when asked directly by a
Speaker 2: reporter if NATO allies should take down Russian aircraft during
Speaker 2: his meeting on the sidelines of the UN General Assembly. Again,
Speaker 2: the read on this that seems pretty pretty straightforward.
Speaker 4: Essentially, Well, it's that's been an interesting developing story all day. Yeah,
Speaker 4: all just in the past few hours. I mean, essentially,
Speaker 4: Trump is giving his blessing for others to do what
Speaker 4: he is not willing to have the US get involved in.
Speaker 4: But at the same time, it's still kind of contradicts
Speaker 4: or or at least is at odds with the tone
Speaker 4: and tenor of what his Secretary of State Mark Rubio
Speaker 4: said earlier in the day when he was asked about
Speaker 4: the Polish leader's tusk, his comments on being willing to
Speaker 4: shoot down a Russian aircraft and Rubio kind of dismissed
Speaker 4: that and had a kind of a vague line around,
Speaker 4: you know, diminishing that sort of prospect. But Trump now saying, yeah,
Speaker 4: go for it. Basically, if they're invading your airspace, NATO allies,
Speaker 4: you know, take them down. So he's certainly kind of,
Speaker 4: as we say, kind of ratcheting up his leverage against
Speaker 4: Putin in frustration over and not talking to each other. Yeah, yeah,
Speaker 4: it certainly feels that way.
Speaker 5: What love that the US actually has when it comes
Speaker 5: to put has been trial well certainly.
Speaker 4: I mean there's a lot on the economic front. You know,
Speaker 4: in successive administrations you always ask, you know, what more
Speaker 4: can be sanctioned? But you know, as the Treasury Department
Speaker 4: always says, and the US presidents have successively said, you know,
Speaker 4: there's there's always more that we can do. And certainly
Speaker 4: in Trump's portfolio, which has been very openly exposed in
Speaker 4: terms of what he wants to do on policy, to
Speaker 4: ratchet up against Russia, he could move a little bit
Speaker 4: further to pressure other countries, including uh India and China
Speaker 4: and perhaps Hungry as came up earlier today, to cease
Speaker 4: their Russian energy purchases. He's already putting more pressure on
Speaker 4: European partners to do so, and saying, you know, you
Speaker 4: can't be hypocritical about this. If if you want me
Speaker 4: to apply these renewed penalties, you have to do it
Speaker 4: yourself as well. So he's offering Trump is offered different
Speaker 4: options for ratcheting up that pressure on putin Economically.
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Speaker 2: All right, we should keep in mind that we really
Speaker 2: saw a lot of unity at the most recent FED meeting.
Speaker 3: Some dissenters the meeting beforehand.
Speaker 2: Meantime, if you're at the UN this morning, there were
Speaker 2: no calls for unity. Instead, President Trump sailed the United
Speaker 2: Nations and other countries in a grievance laden's speech that
Speaker 2: accused the world body of offering nothing but empty words,
Speaker 2: labeled climate change a con job, and warned open borders.
Speaker 3: Risks destroying nations.
Speaker 2: You also criticized the organization that housed his morning address.
Speaker 6: I ended seven wars dealt with the leaders of each
Speaker 6: and every one of these countries and never even received
Speaker 6: a phone call from the United Nations offering to help
Speaker 6: in finalizing the deal. What is the purpose of the
Speaker 6: United Nations? The UN is such tremendous potential. I've always
Speaker 6: said it. It has such tremendous, tremendous potential. But it's
Speaker 6: not even coming close to living up to that potential
Speaker 6: for the most part, at least for now. All they
Speaker 6: seem to do is write a really strongly worded letter
Speaker 6: and then never follow that letter up. It's empty words,
Speaker 6: and empty words don't solve war.
Speaker 2: That, of course, was President President Trump. Excuse me, addressing
Speaker 2: the UN General Assembly this morning? Do you want to
Speaker 2: mention a headline crossing President Trump to meet with the
Speaker 2: head of France, mister Macron, and also the head of
Speaker 2: Uzbekistan while in New York City? So these headlines are
Speaker 2: going to continue to come with more in the President's spech.
Speaker 3: You want to go write to it.
Speaker 2: Josh wing Grove is in the House, not in DC.
Speaker 2: He's Bloomberg, new senior White House correspondent.
Speaker 3: Josh. You cover the president all his twists and turns.
Speaker 3: This was an interesting speech.
Speaker 7: It was it's great to be here, great to happen
Speaker 7: person is a rare treat for us here. Look, the
Speaker 7: Trump Show hits the road every once in a while,
Speaker 7: and you know, the aperture opens and welcome, Welcome to
Speaker 7: the second term. You know, he hit a lot of
Speaker 7: themes that he'd hit previously in this, although probably more
Speaker 7: strongly than in the past. Basically, he sort of assailed
Speaker 7: the UN over as you mentioned, climate and immigration is
Speaker 7: two big topics, going so far as to basically completely
Speaker 7: dismiss the notion of climate change as a hoax, but
Speaker 7: also on immigration, saying that it's the single biggest political
Speaker 7: issue of our era. So trying to draw the draw
Speaker 7: line in the sound. But Trump being Trump, he talked
Speaker 7: about the teleprompter not working. This was sort of a
Speaker 7: bit of his in the campaign. Let's just say it's
Speaker 7: open to interpretation whether that was actually the case or not.
Speaker 7: The uens that the teleprompter was working fine, of course
Speaker 7: was yeah, But then was griping about the escalator.
Speaker 5: That was fine, that.
Speaker 7: Was not I can confirm the escalator was not working,
Speaker 7: and then later was working. It seemed to get under
Speaker 7: his skin and that's when he went off about the
Speaker 7: renovation that he wished he'd done and told them, you know,
Speaker 7: you could be walking on marble, you're walking on tarazzo flooring,
Speaker 7: you know that, right, So you know it's it was
Speaker 7: a journey a weave, as President Trump likes to say.
Speaker 7: But I think it just underscores not only is long
Speaker 7: standing disdain for the UN. Remember, the US is delinquent
Speaker 7: right now and it's fun to support the UN. Trump
Speaker 7: is given no indication that he plans to change that,
Speaker 7: but also the kind of new grievances are adding on.
Speaker 7: In particular, he thinks he you know, he's obviously kind
Speaker 7: of gently somewhat campaigning for a Nobel prize. He talks
Speaker 7: about ending seven wars and he's wondering where the UN
Speaker 7: has been. He sort of wanted credit for it, said
Speaker 7: they didn't get a phone call. But Trump being Trump,
Speaker 7: you know, he got off stage, sat down with Gutara's
Speaker 7: and then was all smiles and nice. So picker Lands,
Speaker 7: I suppose.
Speaker 5: Yeah, even mentioning other leaders who he had said things about,
Speaker 5: but then at run into personally, essentially saying, you know,
Speaker 5: I ran into this person. I can't believe to be
Speaker 5: talking about this, and it's kind of for you who
Speaker 5: covers Trump covers the president. It's not surprising because that's
Speaker 5: the way he is. But for world leaders who are
Speaker 5: sitting there, who are not necessarily accustomed to following every
Speaker 5: comment that he makes, especially at the UN, this was unconventional.
Speaker 7: I think that that's I think that's right to say. Yeah,
Speaker 7: I mean, if you're being sort of re onboarded into
Speaker 7: a Trump spech after maybe six years it had been
Speaker 7: since his last one, for sure, this is going to
Speaker 7: take you by storm. I do think that there are
Speaker 7: things to watch that we'll make news today, for sure,
Speaker 7: beyond the speech, including the bilateral with President of Zelensky,
Speaker 7: which should be wrapping up just as we speak, right
Speaker 7: or just has wrapped up. Trump has really shifted on
Speaker 7: Zelensky a lot. He said today that it's remarkably brave
Speaker 7: what the Ukrainians are doing. That is a big shift
Speaker 7: in tone from January, and so that one we're watching
Speaker 7: you sort of tacitly endorse the notion of NATO nations
Speaker 7: shooting down Russian planes?
Speaker 5: Does that have to do with the recent violations of
Speaker 5: airspace that we've seen.
Speaker 7: I think I personally would read that more as a
Speaker 7: Trump sort of handwavy type of comment. I would not
Speaker 7: read that as like an emphatic shift in US policy.
Speaker 7: He sort of danced around the drone an issue. He
Speaker 7: danced around it again in a separate answer today, but
Speaker 7: he did say flatly yes, he thinks that NATO should
Speaker 7: have the right to shoot down Russian planes, not drones,
Speaker 7: if they incur on NATO airspace. So we'll see. As
Speaker 7: you know, this is speaking of long time agrievmances. It
Speaker 7: wasn't just the UN. NATO, of course, he has had
Speaker 7: sort of a bumpy ride with but he's been more
Speaker 7: pro NATO as of late, in particular touting the increased
Speaker 7: defense spending pledges from Europe and Canada and other you know,
Speaker 7: allies generally. So I think I think you know that one.
Speaker 7: We got a lot of eyes on this Macrone meeting
Speaker 7: could be interesting. He made a little bit of news
Speaker 7: last night wandering the streets of New York upset about
Speaker 7: the president's MOTORCN. What we can all relate to that.
Speaker 5: Everybody knows a city bike is the way to go
Speaker 5: during the UN General Assembly. So if only he had
Speaker 5: a helmet, maybe would have seen the French leader on
Speaker 5: the city.
Speaker 7: But we can we can know lovely, Yes, yeah, we get,
Speaker 7: but that'll be going. Trump is hosting a reception tonight.
Speaker 7: We don't actually know who's going, so we don't know
Speaker 7: if this is sort of a friend's only thing, like
Speaker 7: you know, Mela and the other whatevers, or if it's
Speaker 7: a broader thing. So we'll see. We don't know right
Speaker 7: now whether they'll let the press in. But I'll be
Speaker 7: there waiting, open, praying.
Speaker 5: Hey, I'll be here outside, waiting on your city bank.
Speaker 3: In your city bike.
Speaker 2: I mean, against everything else that's going, we're still doing
Speaker 2: stories about the H one B visas. I mean, there's
Speaker 2: just so much josh when you look at the president.
Speaker 2: I don't know how you guys do it, because there's
Speaker 2: so much coming at you top of the White House
Speaker 2: agenda right now, because sometimes I feel like, watch here, guys,
Speaker 2: but don't look at here, which is maybe something impactful.
Speaker 2: I don't know how are you sussing out kind of
Speaker 2: what matters right now when it comes to the White House.
Speaker 7: I mean Trump always likes to flood the zone. That's
Speaker 7: been a consistent theme throughout his presidencies. I think on
Speaker 7: the H one B thing, this is a big change
Speaker 7: and it's a little unclear to me whether they're shifting
Speaker 7: it on the fly. Remember they have their big announcement Friday.
Speaker 7: Everyone's brain's exploded on Saturday. They started to, let's say detail.
Speaker 7: Critics might say, walk back some of the things. For instance,
Speaker 7: Secretary of Latini said things on Friday that have not
Speaker 7: ultimately been the policy. And today the new development is
Speaker 7: sort of getting rid of the lottery system. We knew
Speaker 7: that was happening. Trumpet signaled before the whole one hundred
Speaker 7: thousand dollars fee thing that that was happening. But this
Speaker 7: is a you know, huge change, and so they you know,
Speaker 7: whether it's impact on the tech sector, on healthcare, all
Speaker 7: this is really up in the air right now. And
Speaker 7: it's you know, part and parcel obviously with a complete
Speaker 7: overhaul of the American immigration system as he sees it. So,
Speaker 7: you know, people that have each one these now are
Speaker 7: breathing a sigh of relief because there was a moment
Speaker 7: there where they were like, oh, shoot, we got to
Speaker 7: get back on us soil, you know, in hours. But
Speaker 7: it doesn't look like that's the case. So for now,
Speaker 7: that's the shiny thing we're looking at it.
Speaker 2: So while you're here in town. Come back, yes, Josh
Speaker 2: wing Grove. He is Bloomberg News Senior White House correspondent, Josh.
Speaker 2: Thank you as oways.
Speaker 5: Stay with us. More from Bloomberg Business Week Daily coming
Speaker 5: up after this.
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Speaker 8: flagship New York station, Just Say Alexa played Bloomberg eleven thirty.
Speaker 5: Federal agents dismantled a network of devices in the New
Speaker 5: York area that was used to threaten senior US government
Speaker 5: officials and bore signs of foreign involvement. This according to
Speaker 5: the US Secret Service, agents discovered more than three hundred
Speaker 5: simcard servers and one hundred thousand simcards in several locations
Speaker 5: within a thirty five mile radius of New York City.
Speaker 5: That's according to a statement on Tuesday. The Secret Service
Speaker 5: moved quickly, given that any attack could have severely disrupted
Speaker 5: New York at a time when world leaders are gathering
Speaker 5: in the city for a meeting of the UN General Assembly.
Speaker 5: I want to bring in Jennifer Ubank. She's the founder
Speaker 5: of and a Man, a strategic advisor. She works with
Speaker 5: companies on cyber resilience, geopolitical risk, and more. She's also
Speaker 5: a former Deputy director of the CIA for Digital Innovation.
Speaker 5: She joins us from Virginia. Jennifer, good to have you
Speaker 5: back with us this afternoon. I want to talk about
Speaker 5: what the Secret Service discovered here. What does an attack
Speaker 5: like this mean, or a potential attack like this mean?
Speaker 5: What would be the goal of something like this? What's
Speaker 5: your view?
Speaker 9: Wow, thanks for the invitation today, and man, there's never
Speaker 9: a dull day in national security or cyber is there?
Speaker 9: And today's obviously no exception. So what I'd say is
Speaker 9: this is quite literally unprecedented activity in its scale, and
Speaker 9: I would say audacity right just that you cited all
Speaker 9: the figures in its eye watering. What would have gone
Speaker 9: into planning such an activity? And so great question to
Speaker 9: start with is why what is that for? And I
Speaker 9: think officials who have been working on this have very
Speaker 9: smartly been cautious about attribution so quickly because they're still investigating.
Speaker 9: But I think you can look at it as maybe
Speaker 9: three or three different bins. So there first there's disruption
Speaker 9: this network. This technology could have taken out cellular communications,
Speaker 9: emergency communications, and enabled you encrypted communications amongst various actors.
Speaker 9: So disruption would have been one possible explanation. Another is threats.
Speaker 9: I mean, it seems like a lot of technology for that,
Speaker 9: but there are some anecdotal reports of threats against US
Speaker 9: officials being made from some of these devices and through
Speaker 9: these means. And then the third one, you know, could
Speaker 9: be some sort of criminal enterprise or clandestine network operating
Speaker 9: on a large scale. And certainly the timing around the
Speaker 9: one general assembly, the location of the equipment, all of
Speaker 9: that suggests something more. And be very eager to see
Speaker 9: what officials start to say as they come up with
Speaker 9: more details.
Speaker 2: You know, Jennifer, when something like this happens, how do
Speaker 2: they know that it's signs of foreign involvement versus domestic involvement.
Speaker 9: Yeah, that's a really great question, and there's there's been
Speaker 9: a speculation in there, because, as I mentioned, officials are
Speaker 9: being quite close lipped at this point because they're deep
Speaker 9: into investigating to get the details. But there have been
Speaker 9: anecdotal reports of some sign ups of connection between actors
Speaker 9: using this stuff and at least somebody in a foreign
Speaker 9: official position. You know, I think it's really important not
Speaker 9: to go too far down that avenue of speculation. But
Speaker 9: they'll be looking. Investigators will be looking for these kinds
Speaker 9: of connections because of course the digital footprint is out
Speaker 9: there to be investigated. So they'll be combing through that
Speaker 9: using probably technical tools, using AI, using link analysis, using
Speaker 9: all sorts of things to see if they can put
Speaker 9: together a picture of who might be communicating with whom
Speaker 9: through this system that would help them understand who might
Speaker 9: be behind it.
Speaker 2: Matt McCool, the Special Agent in charge of the Secret
Speaker 2: Services New York Field Office, said the seizure was the
Speaker 2: largest operation of its kind the agency had undertaken.
Speaker 3: I mean size and scope.
Speaker 2: I mean, I'm assuming that there's stuff going on all
Speaker 2: the time between nations and so on, but give us
Speaker 2: an idea. I mean, how big this operation seemed to be.
Speaker 9: Yeah, it's almost unimaginable, right, just the volume, the scope,
Speaker 9: and you cited the metrics up front. So three hundred
Speaker 9: SIM servers, one hundred thousand SIM cards, all kind of
Speaker 9: spread across a region. That is unprecedented. It really is.
Speaker 9: And I think the word I used at the beginning
Speaker 9: was it's audacious as well. It truly is, and so
Speaker 9: having come out of the world of intelligence for decades,
Speaker 9: I have never seen an activity like this. So I'm
Speaker 9: going to be tracking this one very closely. Really want
Speaker 9: to understand a kind of how it was done. Obviously
Speaker 9: why it was done with the potential impact could have been.
Speaker 9: But bravo to all of the law enforcement and national
Speaker 9: security officials who work together to thwart this, because who
Speaker 9: knows which path it could have taken. Was it to
Speaker 9: be disruption, which would have been you know, real pain
Speaker 9: and hu the word. We couldn't have facilitated threats? Could
Speaker 9: it have launched some other criminal activity? We don't know.
Speaker 5: Yeah, I think the question is to what end, Like,
Speaker 5: what would be the purpose of, you know, messing with
Speaker 5: a communication system such as that. One question that I
Speaker 5: have is about the communication of this, of this terror
Speaker 5: plot or alleged terror plot that was thwarted, and why
Speaker 5: the Secret Service communicated this, why they showed us pictures
Speaker 5: and if that's rare to do in a situation such
Speaker 5: as this.
Speaker 9: It's interesting because I'm not sure we ever have had
Speaker 9: a situation like this, so that we know, yeah, yeah, Well, yes, okay.
Speaker 3: Because they did the great reveal there.
Speaker 9: We go, There we go. This is the first that
Speaker 9: was ever revealed. But I'm going to suggest that this
Speaker 9: is this is unique in its nature in terms of
Speaker 9: the scale and the scope.
Speaker 5: But is it unique to communicate? Is it unique to
Speaker 5: communicate a win such as this? Does a lot of
Speaker 5: stuff happen behind the scenes that we don't know out
Speaker 5: each and every day That keeps us safe?
Speaker 9: Absolutely, And I'm and I have to believe this was
Speaker 9: not as if you know, discovered that moment and then
Speaker 9: they came out and have press release. There is a
Speaker 9: lot of work that went to getting to this point,
Speaker 9: I have to believe. And so one of the one
Speaker 9: of the good things that has been emphasized in government,
Speaker 9: certainly on the national security side and law enforcement side,
Speaker 9: has been transparency. And so maybe we're seeing a reflection
Speaker 9: of that. And it's always difficult because you don't have
Speaker 9: all the details. You know, people want more detail, but
Speaker 9: if you don't release information, then you know, people are
Speaker 9: frustrated about that. Can I can I make one point
Speaker 9: about this though? I think it's really important because if
Speaker 9: it's super interesting, I'm going to be really focused on
Speaker 9: this for for some time until it all is unraveled.
Speaker 9: But it really does showcase that telecommunications is a frontline
Speaker 9: national security issue right now. And so we've we've talked
Speaker 9: previously about intrusions like Salt Typhoon, that was the massive
Speaker 9: uh prc ansored intrusions into our telecommunications networks across the country.
Speaker 9: We are just seeing telecommunications in various ways just right
Speaker 9: in the crosshairs of very capable state cyber actors and
Speaker 9: criminal networks. Now we don't know which one this is
Speaker 9: or if it's both, We don't have any idea just yet,
Speaker 9: but both are very very focused on telecommunications and that
Speaker 9: has economic impacts. It has security impacts on the ground.
Speaker 9: If we talked about nine to eleven, a nine to
Speaker 9: one line, excuse me, nine to one one being disrupted
Speaker 9: or other communications has business impacts across every sector. So
Speaker 9: it's something that we really need to watch in this
Speaker 9: coming year.
Speaker 2: Fifteen seconds. Do we need global cooperation to stay on
Speaker 2: top of it or we just need to have a
Speaker 2: domestic focus on it real quickly.
Speaker 9: Absolutely, it is global. It is a global issue. We
Speaker 9: need to have partnerships all around the world. We need
Speaker 9: to emphasize public private partnerships in the US industry. Companies
Speaker 9: are going to see things that government does, but government's
Speaker 9: going to have strategic insights and re sources that individual companies.
Speaker 1: Yeah.
Speaker 2: Jennifer You, Bank Marnerships founder Vandermann Strategic Advisors, joining us
Speaker 2: from Virginia.
Speaker 5: Stay with us. More from Bloomberg Business Week Daily coming
Speaker 5: up after this.
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Speaker 5: Watching shares a ken view. The parent company of Tail
Speaker 5: and All really been bouncing around quite a bit in
Speaker 5: the last couple of days, up to two point three percent,
Speaker 5: recouping some of Monday's drop. This is President Trump's call
Speaker 5: for pregnant women to avoid Tail and All drue sharp
Speaker 5: criticism from researchers to say the advice ignores decades of
Speaker 5: evidence and could endanger mothers and babies. For more, We're
Speaker 5: joined by Jessica Nicks, Bloomberg News health reporter. Jessica You
Speaker 5: and the team out with a story this afternoon about
Speaker 5: mounting confusion for patients. You all spoke to Bussians about this,
Speaker 5: What did you find? How did they respond?
Speaker 10: Yeah, most physicians today are just generally confused about the
Speaker 10: guidance that's coming out. How are they going to interpret this?
Speaker 10: But a few of them are saying, you know, we're
Speaker 10: going to keep continuing on as normal, keep talking to
Speaker 10: our patients about what works for them, what doesn't work
Speaker 10: for them.
Speaker 5: You know one thing that's interesting here, and we're going
Speaker 5: to be speaking to doctor Todd Ivy, a fellow in
Speaker 5: the American College of Obstetricians. In just a minute, the
Speaker 5: organization is out with a statement that says it's irresponsible
Speaker 5: and still what they've heard from President Trump and still
Speaker 5: recommends tylanold during pregnancy. How atypical is it for a
Speaker 5: professional group such as the Academy of the American College
Speaker 5: of Obstetricians to recommend something that's counter to something that
Speaker 5: a government body such as the HHS would suggest.
Speaker 10: If you asked me that question a year ago, I
Speaker 10: would say very abnormal. This year, this is like the
Speaker 10: second or third time a American medical organization has gone
Speaker 10: against the advice of HHS. Notably, we've seen a COG
Speaker 10: do different advice than HHS on vaccines, specifically for pregnant
Speaker 10: women and taking COVID vaccines.
Speaker 2: Sorry, well, I want to put that question to doctor
Speaker 2: Todd Ivy. He's fellow in the American College of Obstetricians,
Speaker 2: which is the professional membership organization of obgyns, and associate
Speaker 2: professor at Baylor College of Medicine, former president of the
Speaker 2: Houston obgyn Society. So doctor Ivy weigh in on this.
Speaker 2: If it's recommended that maybe pregnant patients don't use tile
Speaker 2: and all, I don't know a recommendation from the government,
Speaker 2: how do you read it?
Speaker 3: Would you not recommend it to a patient?
Speaker 11: No, actually, I would absolutely recommend it When we look
Speaker 11: back at the data, and this has been looked at.
Speaker 11: Remember we have over twenty years of research around this.
Speaker 11: There has never been proven causation for cedominifit to any
Speaker 11: neurodevelopmental disorder during pregnancy. However, we know that the uses
Speaker 11: of ceedominefit in pregnancy for chronic pain, paint, persistent headaches,
Speaker 11: and particularly fever reduction are incredibly important and not dealing
Speaker 11: with those issues can lead to additional complications your in pregnancy.
Speaker 2: One thing I want to ask you doctor Ivy, And
Speaker 2: I've seen this certainly in the obgyn area that your
Speaker 2: medical malpractice insurance is off the charts, And I'd had
Speaker 2: obgyn who talked about a million dollars a year and
Speaker 2: gave up the ob part of it because it was
Speaker 2: so expensive. What I'm curious about, though, is if you
Speaker 2: have a government saying maybe you shouldn't do this, does
Speaker 2: this potentially put you guys in a legal situation or
Speaker 2: legal quandary where you could be more of a target
Speaker 2: if something bad happens.
Speaker 11: Well, that would be a concern for any of this. However,
Speaker 11: I think it's important to really you know what I'm saying.
Speaker 2: If the government's coming out saying maybe you shouldn't do this,
Speaker 2: and you guys say, Nope, this makes sense. You've seen
Speaker 2: the research, the study, and then something goes astray. Is
Speaker 2: there a kind of you know, a new twist in
Speaker 2: all of this now and how you might approach something.
Speaker 2: Are you still going to say, Nope, it makes sense,
Speaker 2: I'm going to do it.
Speaker 11: Well, you would have to prove causation, okay, and I
Speaker 11: don't think that's able to be proven, and looking at
Speaker 11: the highest quality data, the best study designs it's never
Speaker 11: been shown to be linked, and so I don't think
Speaker 11: that would stand. Certainly, that would be a concern because
Speaker 11: we always want to do the right thing. That's really
Speaker 11: important to us, you know, but I think it would
Speaker 11: be difficult to prove.
Speaker 10: Well, speaking doctor ivy of the causation doesn't always equal
Speaker 10: association in some of these studies. Talk to us about
Speaker 10: some of the studies that the Trump administration pointed to
Speaker 10: yesterday as the reason to come out with these new recommendations.
Speaker 11: Well, you know, there's there's been questions around this for
Speaker 11: a long time, and what we've seen. Even the Society
Speaker 11: for Maternal Fetal Medicine and the FDA itself in twenty
Speaker 11: seventeen and twenty fifteen did reviews and did not find
Speaker 11: any causation. However, there was a consistent statement that was
Speaker 11: released in the journal Nature that suggested that maybe there
Speaker 11: could be some type of link. Well, ten new studies
Speaker 11: have been released since that time that have clearly refuted this.
Speaker 11: The best study I think is the one released in
Speaker 11: the Journal of the American Medical Association in twenty twenty four,
Speaker 11: which looked at over two point five million children two
Speaker 11: point five million, and they actually took into account some
Speaker 11: of the confounding variables that the poorly designed studies did not,
Speaker 11: and so they actually took siblings and matched them for
Speaker 11: a control group, meaning one sibling would get the tailanol
Speaker 11: in utero and one sibling would not proved there was
Speaker 11: no relationship that was proven.
Speaker 5: I just want to mention ken View coming out over
Speaker 5: the weekend with a statement on this. They said, quote,
Speaker 5: this is the parent company of Talanal quote. We believe
Speaker 5: independent sound science clearly shows that taking a seat of
Speaker 5: minifin does not cause autism. We strongly disagree with any
Speaker 5: suggestion otherwise and are deeply concerned about the health risks
Speaker 5: and confusion this poses for expecting mothers and for parents.
Speaker 5: Doctor Ivy, the president said yesterday he suggested that pregnant
Speaker 5: women should tough They should they should only use talent
Speaker 5: all control of fever if they can't tough it out
Speaker 5: from a medical perspective. And those are his words, quote
Speaker 5: tough it out from a medical perspective, in a medical
Speaker 5: communication perspective. And I know that medical students study medical communication.
Speaker 5: How do you look at messaging such as that coming
Speaker 5: from the leader of the country.
Speaker 11: Well, I think that's very unfortunate statement. I think pregnancy
Speaker 11: can be very difficult for some women, and I think
Speaker 11: telling them to quote toughened it out is really a
Speaker 11: poor approach. Now, I think before any medicine is taken
Speaker 11: in during pregnancy, whether it's an over the counter medicine
Speaker 11: or prescription medicine, a conversation with your healthcare provider is
Speaker 11: in order. And if they see fit, then I think
Speaker 11: you need to take the recommended dose for the shortest
Speaker 11: amount of time. And again, you know, no more than
Speaker 11: is recommended.
Speaker 2: You know, you bring up autism, anybody brings up autism,
Speaker 2: and it's it's a very difficult situation.
Speaker 3: It's a spectrum.
Speaker 2: I know individuals who have kids who are now adults,
Speaker 2: who are artistic, and it's it's a difficult thing. And
Speaker 2: I think we're still trying to figure out what is
Speaker 2: the cause? What are you know, the causality, What are
Speaker 2: the connections genetic or otherwise, I mean, what is How
Speaker 2: do you think about autism? You know, and I'm sure
Speaker 2: you've seen it, unfortunately in some of the flks who
Speaker 2: have had kids. I mean, how are we It's still
Speaker 2: there's a lot unknown, correct, And I understand everybody's looking
Speaker 2: to try and make sense of it. But I'm just curious,
Speaker 2: what's the smart medical thought around autism.
Speaker 11: I think you hit the nail on the head. There
Speaker 11: is a spectrum, there is a lot that is unknown.
Speaker 11: There's a lot more that we need to find out
Speaker 11: about it. You know, we know that it is a
Speaker 11: disorder of the way people receive, process and communicate and
Speaker 11: interact with their environment. There will probably be the cause
Speaker 11: will probably be multifactorial, and I think we it's going
Speaker 11: to be an interplay of how things come together. But
Speaker 11: I think it's very unfortunate in families where a child
Speaker 11: has autism and to indicate that the mother or the
Speaker 11: parents did something wrong that costs this the guilt with
Speaker 11: that would be tremendous. In my opinion, is completely completely unnecessary.
Speaker 10: One thing that also came out of the administration yesterday
Speaker 10: is they're now recommending this new drug called leucovin as
Speaker 10: a potential treatment for autism. Can you tell us a
Speaker 10: little bit about the science behind that. Why they're pointing
Speaker 10: to this drug that's typically used for chemotherapy treatment and
Speaker 10: pain management.
Speaker 11: It is, it's lukavorin, and it actually is a form
Speaker 11: a more naturally occurring form of fullic acid. You know,
Speaker 11: folic acid has been important in pregnancy for years now.
Speaker 11: We know that it's related to neural tube defects, you know,
Speaker 11: or the lack of it is related to neural tube defects.
Speaker 11: So we've always recommended fullic acid during pregnancy. And in reality,
Speaker 11: what makes a prenatal vitamin prenatal than just a regular
Speaker 11: vitamin is the amount of follic gas set. Now. I
Speaker 11: think many more studies need to be done on this.
Speaker 11: The main use of luca orn is exactly what you say,
Speaker 11: and people who take chemotherapeutic drugs, whether it's for cancer
Speaker 11: or whether it's for arthritis, and it can offset some
Speaker 11: of the side effects of that, but I think it's
Speaker 11: it's as the drug of treatment. I think much more
Speaker 11: needs to be studied.
Speaker 5: Well, what do we know of scientifically, and this is
Speaker 5: to Carol's and Jessica's question too, what do we know
Speaker 5: scientifically about the causes of autism?
Speaker 11: Well, we know that they're like I said, it's multi factoral.
Speaker 11: We know that there are many genetic causes. In some
Speaker 11: of my own patients, when we've done genetic analysis, we
Speaker 11: found different gene mutations and deletions that we know are
Speaker 11: associated with autism. There are likely some environmental factors that
Speaker 11: come into play as well. But our concern about some
Speaker 11: of these studies that they based some of these decisions
Speaker 11: on that they were poorly designed. They actually depended on
Speaker 11: a recall of patients about how much they took, and
Speaker 11: there's always a bias when you tried to do recall.
Speaker 11: They had limited information on dosages and duration of exposure,
Speaker 11: so you really cannot draw scientific conclusions from such poorly
Speaker 11: designed studies.
Speaker 3: I just want two things.
Speaker 2: Luca Vorn though full of acid, I remember taking it
Speaker 2: in a big way, So it's not really something new.
Speaker 11: It's not new. It's not new at all. We have
Speaker 11: learned so much about neural tube defects, which is a
Speaker 11: defect in the development of the neural tissue in the fetus,
Speaker 11: and we know that folic acid is incredibly important in
Speaker 11: the proper development of that.
Speaker 3: So I want to follow because we do know.
Speaker 2: In the great reporting by our team of Brett Pulley,
Speaker 2: Jessca Nixon, Madison Muller talking about these doctors at OBGYN
Speaker 2: practices in Atlanta, fielding a lot of questions. I'm assuming
Speaker 2: you are feeling in questions as well about all of this.
Speaker 2: I am curious, do you feel or do doctors have
Speaker 2: a voice in Washington and are getting time with the AHHS,
Speaker 2: Robert F. Kennedy, the secretary, or even with the White House.
Speaker 11: I think we've had somewhat of a difficult time doing that.
Speaker 11: You know, it seems to be recently that some of
Speaker 11: the scientific evidence is being ignored. I think that's very
Speaker 11: dangerous for patients. When patients come in and ask us
Speaker 11: about these things, you know, we share decision making is
Speaker 11: what we call it, where we talk to the patient
Speaker 11: about the risks of not taking a certain treatment, a
Speaker 11: certain vaccination, a certain medication. We talk about the risks
Speaker 11: and we talk about the benefits of each and patients,
Speaker 11: in consultation with their healthcare providers, need to make those decisions.
Speaker 10: Well, speaking of some of this confusion that we're seeing
Speaker 10: coming out about tail and al and autism too, a
Speaker 10: lot of pregnant women are now also looking at what
Speaker 10: do we do about a COVID shot? So how can
Speaker 10: patients look at all this confusing messaging coming out of
Speaker 10: the administration that's in conflict with what medical doctors are
Speaker 10: saying and how can they navigate this world right now?
Speaker 11: Well, I think looking to your healthcare provider is the
Speaker 11: best place to go. I think we're relying on scientists,
Speaker 11: physicians and healthcare providers to provide the best medical evidence.
Speaker 11: Then the highest quality medical evidence. You know, we always
Speaker 11: say that we practice evidence based medicine in that we
Speaker 11: do that, and as science changes, we change our recommendations.
Speaker 11: But science hasn't changed on this. I just think someone's
Speaker 11: statement on this has changed. And so we still recommend
Speaker 11: the COVID vaccinations. I had one myself. We still recommend
Speaker 11: flu shots duringnancy, we still recommend the t edapp, and
Speaker 11: we're now recommending RSB RSV rather than the respiratory sensitial
Speaker 11: virus vaccination during pregnancy.
Speaker 2: One last question, do we have to be worried that
Speaker 2: there's not going to be enough vaccines because there's kind
Speaker 2: of interesting messaging and messaging that maybe not everybody needs
Speaker 2: the vaccine?
Speaker 11: Well, I hope not. That's always a concern. Supply is
Speaker 11: always a concern. We're finding patients coming in and requesting
Speaker 11: the COVID vaccinations and we're having to send them out
Speaker 11: to pharmacies, and some pharmacies have them and some are not.
Speaker 11: Some patients are having to look for them in order
Speaker 11: to receive them. You know, I've always been a believer,
Speaker 11: you know. I am am sixty three years old, and
Speaker 11: I had the measles, I had the mumps, I had
Speaker 11: the chicken pox when I was a child, and I
Speaker 11: remember those and I remember my sister looking at my
Speaker 11: face and saying, what are those pumps on your face?
Speaker 11: You know, And that's how we know I was diagnosed.
Speaker 11: You know, I received the polio vaccine when I was
Speaker 11: a child, and so I feel like I've lived a
Speaker 11: great life with the benefit of vaccinations. And I think unfortunately,
Speaker 11: our memories are often short, and sometimes the younger generation
Speaker 11: doesn't realize the benefits of what they've they've they've had.
Speaker 6: You know.
Speaker 11: I also remember the days of being an OBGM provider
Speaker 11: when the pandemic first started, and seeing, you know, on
Speaker 11: our local TV station, seeing the freezer trucks outside hospitals
Speaker 11: in El Paso where they were placing the bodies of
Speaker 11: people that deceased from COVID, you know, you know, hearing
Speaker 11: the stories of nurses that left Houston and went to
Speaker 11: New York to work, you know, in some of these
Speaker 11: COVID units. I had several patients that did that, and
Speaker 11: it's gut wrenching, and I really hope people will stop,
Speaker 11: take a deep breath and really listen to the high quality,
Speaker 11: evidence based research that's out there and pay attention to
Speaker 11: what your healthcare providers are telling.
Speaker 5: Well, doctor Ivy, we really appreciate you taking the time
Speaker 5: in joining us this afternoon. That's doctor Todd Ivy, Fellow
Speaker 5: in the American College of Obstetricians and Associate professor at
Speaker 5: Baylor College of Medicine. Also former president of the Houston
Speaker 5: Obgyn Society. Also with us Jessica Nix, our Bloomberg News
Speaker 5: Healthcare Team. Check out her story along with the rest
Speaker 5: of the healthcare team. You can do that on the
Speaker 5: Bloomberg Terminal and at Bloomberg dot com.
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