1
00:00:15,076 --> 00:00:24,236
Speaker 1: Pushkin, this is solvable. I'm Jacob Weisberg. Every state is

2
00:00:24,276 --> 00:00:26,756
Speaker 1: working so hard on this right now. It's a really

3
00:00:26,796 --> 00:00:29,276
Speaker 1: big logistical challenge. Honestly, it's a bit harder in our

4
00:00:29,356 --> 00:00:34,036
Speaker 1: urban areas than our rural areas. As of January twenty

5
00:00:34,076 --> 00:00:37,956
Speaker 1: twenty one, Alaska is number one. It's the US state

6
00:00:38,156 --> 00:00:42,116
Speaker 1: that has vaccinated the largest percentage of its population against

7
00:00:42,156 --> 00:00:46,836
Speaker 1: COVID nineteen. That might seem surprising. Rural areas typically have

8
00:00:46,876 --> 00:00:50,356
Speaker 1: a harder time assessing medical care. They are fewer hospitals,

9
00:00:50,396 --> 00:00:53,836
Speaker 1: fewer doctors and nurses, and it's challenging to deliver medical

10
00:00:53,876 --> 00:00:57,276
Speaker 1: supplies into rugged wilderness. So when it comes to fighting

11
00:00:57,316 --> 00:01:02,276
Speaker 1: COVID nineteen, how has Alaska been so successful reaching remote communities.

12
00:01:02,676 --> 00:01:05,796
Speaker 1: We do have two hundred twenty nine independent sovereign tribes

13
00:01:05,836 --> 00:01:08,196
Speaker 1: in the state of Alaska who have their own distribution.

14
00:01:08,676 --> 00:01:11,036
Speaker 1: We are partnered with them at every level to get

15
00:01:11,076 --> 00:01:13,396
Speaker 1: it out. They've got testing supplies, when they have the

16
00:01:13,396 --> 00:01:15,596
Speaker 1: knowledge and resources, when they have vaccine, they'll get it out.

17
00:01:15,636 --> 00:01:17,796
Speaker 1: Look get it done. They just need the resources to

18
00:01:17,836 --> 00:01:22,356
Speaker 1: do it. Collaboration and coordination among agencies. The Department of

19
00:01:22,396 --> 00:01:26,476
Speaker 1: Defense Veteran Affairs and the Indian Health Service has been

20
00:01:26,516 --> 00:01:30,396
Speaker 1: a big part of Alaska's success. As cities and states

21
00:01:30,436 --> 00:01:34,036
Speaker 1: across the US continue to hone their distribution plans, there

22
00:01:34,036 --> 00:01:37,676
Speaker 1: are lessons to be learned starting with this one. Use

23
00:01:37,836 --> 00:01:41,916
Speaker 1: every resource available. We have had dog slids and helicopters

24
00:01:41,956 --> 00:01:45,916
Speaker 1: and boat up vaccines and ferries and planes and people

25
00:01:45,916 --> 00:01:49,876
Speaker 1: showing up on snowmachine to get vaccinated. Doctor Anne Zinc

26
00:01:49,956 --> 00:01:52,356
Speaker 1: is the chief Medical Officer of the State of Alaska,

27
00:01:52,516 --> 00:01:56,676
Speaker 1: and she believes the challenges of COVID nineteen vaccine distribution

28
00:01:56,916 --> 00:02:02,356
Speaker 1: are surmountable. Distribution of vaccine across rural Alaska is solvable.

29
00:02:04,036 --> 00:02:06,556
Speaker 1: My co host an Apple Bomb, spoke with doctor Zinc

30
00:02:06,596 --> 00:02:09,836
Speaker 1: about some of the unique challenges Alaska faces and what

31
00:02:09,916 --> 00:02:13,156
Speaker 1: we can all learn from their successes across the state.

32
00:02:13,836 --> 00:02:15,596
Speaker 1: That little star at the end of your shipment that

33
00:02:15,636 --> 00:02:17,676
Speaker 1: says you know does not shift to Alaska and Whai

34
00:02:17,876 --> 00:02:20,036
Speaker 1: makes a difference up here. So we've always had to

35
00:02:20,076 --> 00:02:23,436
Speaker 1: have an existing infrastructure and plan for vaccine distribution across

36
00:02:23,436 --> 00:02:25,316
Speaker 1: the state. We've really built on it for the COVID

37
00:02:25,436 --> 00:02:28,956
Speaker 1: nineteen vaccine. It's probably worth mentioning that Alaska is one

38
00:02:28,996 --> 00:02:31,916
Speaker 1: of the five smallest states in the US based on population,

39
00:02:32,396 --> 00:02:34,476
Speaker 1: and a lot of your residents are concentrated in the

40
00:02:34,476 --> 00:02:38,116
Speaker 1: city of Anchorage. But Alaska is also a state with

41
00:02:38,156 --> 00:02:40,676
Speaker 1: a lot of wilderness, and throughout the state their pockets

42
00:02:40,676 --> 00:02:44,676
Speaker 1: of small communities tucked into rural areas. Am I correct

43
00:02:44,676 --> 00:02:48,116
Speaker 1: in imagining? I don't know dog sleds, people on skis.

44
00:02:48,476 --> 00:02:52,836
Speaker 1: Is this too stereotyped? How are you getting vaccines out

45
00:02:52,876 --> 00:02:56,516
Speaker 1: of Anchorage and into the farthest flung communities in your state?

46
00:02:57,076 --> 00:02:59,076
Speaker 1: Things we're asking, I don't think I've ever heard our

47
00:02:59,116 --> 00:03:01,876
Speaker 1: state described as small. We are not very populous, but

48
00:03:01,956 --> 00:03:06,716
Speaker 1: we are larger than Texas, Montana, and California combined, so

49
00:03:06,796 --> 00:03:09,516
Speaker 1: it is a very large geographical space. All those you

50
00:03:09,556 --> 00:03:12,236
Speaker 1: mentioned not many people, and you are not far flung.

51
00:03:12,356 --> 00:03:15,156
Speaker 1: We have had dog slids and helicopters and boat up

52
00:03:15,236 --> 00:03:18,996
Speaker 1: vaccines and ferries and planes and people showing up on

53
00:03:19,036 --> 00:03:22,036
Speaker 1: snowmachine to get vaccinated before the plane takes off to

54
00:03:22,076 --> 00:03:25,116
Speaker 1: the next village. So it's been a pretty interesting and

55
00:03:25,396 --> 00:03:29,676
Speaker 1: beautiful distribution across a wild and wonder estate. And how

56
00:03:29,676 --> 00:03:32,996
Speaker 1: do you normally get medical service to your most rural,

57
00:03:33,076 --> 00:03:36,636
Speaker 1: most far flung residents? Sometimes it is boat a lot

58
00:03:36,636 --> 00:03:39,316
Speaker 1: of airfare. Many of our communities can only be reached

59
00:03:39,316 --> 00:03:41,076
Speaker 1: by air, so there's no roads that go to and

60
00:03:41,156 --> 00:03:44,276
Speaker 1: from them, so we use not only medical air transport,

61
00:03:44,316 --> 00:03:47,036
Speaker 1: but also commercial air transport. We have many small planes

62
00:03:47,036 --> 00:03:49,756
Speaker 1: and small airlines that helps to transport between many of

63
00:03:49,756 --> 00:03:52,476
Speaker 1: our communities. Everything from a swab to bringing in a

64
00:03:52,516 --> 00:03:55,876
Speaker 1: woman who is about to deliver, to getting out vaccine.

65
00:03:55,956 --> 00:03:58,436
Speaker 1: These are all kind of complex logistical challenges that are

66
00:03:58,436 --> 00:04:01,116
Speaker 1: always a part of last with healthcare. Right That's really interesting.

67
00:04:01,196 --> 00:04:03,836
Speaker 1: I'm wondering if in big cities like New York and

68
00:04:04,036 --> 00:04:06,716
Speaker 1: LA where they're having more trouble with the distributing the vaccine,

69
00:04:06,756 --> 00:04:10,676
Speaker 1: it's not because they're lazier. They're not used to having

70
00:04:10,716 --> 00:04:12,596
Speaker 1: to reach out to people in the same way that

71
00:04:12,636 --> 00:04:15,316
Speaker 1: you guys do. Yeah. No, I mean, I think every

72
00:04:15,316 --> 00:04:17,796
Speaker 1: state is working so hard on this right now. It's

73
00:04:17,836 --> 00:04:20,596
Speaker 1: a really big logistical challenge. Honestly, it's a bit harder

74
00:04:20,596 --> 00:04:23,156
Speaker 1: in our urban areas than our rural areas. I mean,

75
00:04:23,196 --> 00:04:25,276
Speaker 1: I think that there's four major reasons we've been able

76
00:04:25,276 --> 00:04:27,836
Speaker 1: to get vaccine out quickly. First of all, I think

77
00:04:28,036 --> 00:04:30,676
Speaker 1: when you have smaller communities, communities can really rally around

78
00:04:30,716 --> 00:04:33,636
Speaker 1: the cry very quickly, and we've just seen tremendous work

79
00:04:33,676 --> 00:04:37,116
Speaker 1: by Alaskans. We do also, our pandemic is kind of

80
00:04:37,156 --> 00:04:39,596
Speaker 1: slowing down here, so that gives more space for our

81
00:04:39,636 --> 00:04:42,916
Speaker 1: public health team as well as the hospital personnel and

82
00:04:43,116 --> 00:04:46,556
Speaker 1: public health nursing and nurses across the state, more space

83
00:04:46,596 --> 00:04:49,596
Speaker 1: and time to be able to respond to the vaccine

84
00:04:49,636 --> 00:04:51,716
Speaker 1: and not having to respond to the pandemic in the

85
00:04:51,756 --> 00:04:56,076
Speaker 1: same sort of way. There's also federal distribution for tribes

86
00:04:56,116 --> 00:04:58,436
Speaker 1: as well as the VA and DoD. We do have

87
00:04:58,476 --> 00:05:01,996
Speaker 1: the highest percentage of veterans than any other state per capita,

88
00:05:02,036 --> 00:05:04,316
Speaker 1: and we do have two hundred and twenty nine independent

89
00:05:04,476 --> 00:05:06,716
Speaker 1: sovereign tribes in the state of Alaska who have their

90
00:05:06,756 --> 00:05:10,236
Speaker 1: own distribution. We are partnered with them at every level

91
00:05:10,276 --> 00:05:11,716
Speaker 1: to get it out. They had a choice to go

92
00:05:11,756 --> 00:05:13,396
Speaker 1: with IHS or to go with the state, and we

93
00:05:13,396 --> 00:05:14,876
Speaker 1: did partner with them to help get that out, and

94
00:05:14,876 --> 00:05:17,956
Speaker 1: I think that partnership is really paying off, both to

95
00:05:17,996 --> 00:05:20,396
Speaker 1: get in their vaccine, get out their vaccine, and to

96
00:05:20,436 --> 00:05:23,716
Speaker 1: be able to coordinate transportation. And then we also are

97
00:05:23,756 --> 00:05:25,796
Speaker 1: being treated kind of like a territory, so we're getting

98
00:05:25,796 --> 00:05:28,516
Speaker 1: month to month allocation, and so that allows us to

99
00:05:28,636 --> 00:05:32,036
Speaker 1: order in, say an entire month's set for a place

100
00:05:32,116 --> 00:05:35,156
Speaker 1: like Adiac that requires a plane and then a helicopter

101
00:05:35,236 --> 00:05:36,956
Speaker 1: to get there and be able to ship that rather

102
00:05:36,996 --> 00:05:38,916
Speaker 1: than having to wait for each week's to come in

103
00:05:39,196 --> 00:05:41,316
Speaker 1: before we can get enough. I mean, many of our communities,

104
00:05:41,356 --> 00:05:43,156
Speaker 1: it might be a vial or a half of a

105
00:05:43,236 --> 00:05:45,956
Speaker 1: vial that might meet the first Phase one A or

106
00:05:45,996 --> 00:05:48,716
Speaker 1: even the beginning of phase one v criteria. By being

107
00:05:48,756 --> 00:05:51,156
Speaker 1: able to kind of pool resources together like that with

108
00:05:51,236 --> 00:05:53,836
Speaker 1: multiple partners, it's really helped us to get vaccine out faster.

109
00:05:54,436 --> 00:05:55,796
Speaker 1: I mean, tell me a little bit more about the

110
00:05:55,876 --> 00:05:59,436
Speaker 1: Native communities in Alaska. I understand it's a very diverse population.

111
00:05:59,596 --> 00:06:04,516
Speaker 1: They're Alaska Natives, American Indian communities, Native Hawaiians, Pacific Islanders.

112
00:06:04,516 --> 00:06:08,596
Speaker 1: And also I understand that they've been disproportionately affected by COVID.

113
00:06:09,196 --> 00:06:11,876
Speaker 1: One report I saw showed that thirty seven percent of

114
00:06:11,876 --> 00:06:14,436
Speaker 1: those who died from the virus in Alaska were Native.

115
00:06:15,596 --> 00:06:18,236
Speaker 1: Is there any special strategy that you need to reach them?

116
00:06:18,276 --> 00:06:20,956
Speaker 1: How do you think about those communities? Thanks for asking that,

117
00:06:20,996 --> 00:06:24,196
Speaker 1: because it is a hugely important topic. Sixteen percent of

118
00:06:24,196 --> 00:06:27,996
Speaker 1: our population as Alaska Native people, yet currently they actually

119
00:06:28,036 --> 00:06:29,796
Speaker 1: make up thirty nine percent of our death so we

120
00:06:29,876 --> 00:06:31,716
Speaker 1: just reran the numbers. They were thirty seven and we

121
00:06:31,836 --> 00:06:34,996
Speaker 1: just random We've seen that with every pandemic from the

122
00:06:35,076 --> 00:06:39,276
Speaker 1: nineteen eighteen pandemic on. We've had communities completely devastated by

123
00:06:39,276 --> 00:06:41,996
Speaker 1: the nineteen eighteen pandemic where language and culture were lost

124
00:06:42,036 --> 00:06:45,556
Speaker 1: in entire orphanages were built, and that history looms large

125
00:06:45,836 --> 00:06:47,876
Speaker 1: in many of our communities and has played a very

126
00:06:47,996 --> 00:06:51,076
Speaker 1: large role in our response from day one to this pandemic,

127
00:06:51,396 --> 00:06:54,436
Speaker 1: remembering that historical trauma and trying to not repeat it.

128
00:06:54,956 --> 00:06:58,036
Speaker 1: Fifty percent of our testing sites are run by the

129
00:06:58,076 --> 00:07:01,276
Speaker 1: native system, again only sixteen percent of the population. We

130
00:07:01,356 --> 00:07:03,116
Speaker 1: have communities where it can take two weeks to get

131
00:07:03,156 --> 00:07:05,516
Speaker 1: a squab out. We've unfortunately had people die where we've

132
00:07:05,556 --> 00:07:08,116
Speaker 1: been unable to get them out or oxygen in because

133
00:07:08,156 --> 00:07:10,716
Speaker 1: the weather has been so bad. In some regions, up

134
00:07:10,716 --> 00:07:12,916
Speaker 1: to sixty percent of the communities have no running water

135
00:07:12,956 --> 00:07:16,276
Speaker 1: and sewer and that makes a really challenging environment to

136
00:07:16,316 --> 00:07:18,556
Speaker 1: be able to fight respiratory infections, and we see high

137
00:07:18,676 --> 00:07:22,396
Speaker 1: rates of respiratory infections in those communities, so it plays

138
00:07:22,396 --> 00:07:23,876
Speaker 1: a really big role in the making sure that we're

139
00:07:23,916 --> 00:07:26,916
Speaker 1: getting equitable distribution and we have a chance for equitable

140
00:07:26,956 --> 00:07:30,676
Speaker 1: outcomes for all Alaskans. And that takes different resources in

141
00:07:30,676 --> 00:07:34,156
Speaker 1: different parts of the country. It takes different resources in Alaska.

142
00:07:34,436 --> 00:07:36,356
Speaker 1: What we found in our communities is when you can

143
00:07:36,396 --> 00:07:39,436
Speaker 1: empower them, they can protect themselves. They've got testing supplies,

144
00:07:39,676 --> 00:07:41,756
Speaker 1: when they have the knowledge and resources, when they have vaccine,

145
00:07:41,796 --> 00:07:43,676
Speaker 1: they'll get it out. They'll get it done. They just

146
00:07:43,756 --> 00:07:46,436
Speaker 1: need the resources to do it. So by empowering you

147
00:07:46,516 --> 00:07:49,396
Speaker 1: mean give them resources directly. I understand that in some

148
00:07:49,436 --> 00:07:52,476
Speaker 1: cases the supply of vaccine did go straight to Native communities.

149
00:07:52,556 --> 00:07:57,036
Speaker 1: Was that logistically important, psychologically important, Yeah, all of the above.

150
00:07:57,116 --> 00:07:59,676
Speaker 1: So HS did have its own distribution and all two

151
00:07:59,756 --> 00:08:03,236
Speaker 1: hundred and twenty nine tribes opted to have the state

152
00:08:03,316 --> 00:08:06,116
Speaker 1: help distribute the vaccine around the state. And that was

153
00:08:06,156 --> 00:08:09,396
Speaker 1: just because we've always had this close working relationship and

154
00:08:09,796 --> 00:08:14,116
Speaker 1: very grateful for that HS allocation and working very hard

155
00:08:14,156 --> 00:08:17,436
Speaker 1: with them to distribute as quickly as possible, particularly to

156
00:08:17,476 --> 00:08:20,036
Speaker 1: the most vulnerable populations, to make sure that they have

157
00:08:20,236 --> 00:08:23,196
Speaker 1: this opportunity to be protected. They can decide on how

158
00:08:23,236 --> 00:08:25,396
Speaker 1: they want to use the vaccine and how they want

159
00:08:25,436 --> 00:08:28,836
Speaker 1: to prioritize it in their community. So, for example, Indigenous

160
00:08:28,996 --> 00:08:32,156
Speaker 1: language speakers have been prioritized by many of our tribal

161
00:08:32,196 --> 00:08:34,956
Speaker 1: communities to make sure that that language continues on. So

162
00:08:35,076 --> 00:08:38,076
Speaker 1: being able to prioritize what's important in that community and

163
00:08:38,116 --> 00:08:40,036
Speaker 1: being able to get vaccine out quickly. Do you think

164
00:08:40,036 --> 00:08:42,796
Speaker 1: that any of these strategies, the things that we're talking

165
00:08:42,796 --> 00:08:46,116
Speaker 1: about would work well in other rural, remote, or rugged

166
00:08:46,156 --> 00:08:50,156
Speaker 1: parts of the United States, Whether it's direct distribution to

167
00:08:50,236 --> 00:08:55,396
Speaker 1: particular regions, whether it's prioritizing even unique methods of transport.

168
00:08:55,396 --> 00:08:58,516
Speaker 1: I mean, can you extrapolate from your experience and imagine

169
00:08:58,556 --> 00:09:00,676
Speaker 1: how it could be used elsewhere. Yeah, it's interesting to

170
00:09:00,716 --> 00:09:02,236
Speaker 1: look at the map and to see, you know, kind

171
00:09:02,236 --> 00:09:04,676
Speaker 1: of who's been able to vaccinate more quickly. It's been

172
00:09:04,716 --> 00:09:06,556
Speaker 1: some of our more rural states when you look at it,

173
00:09:06,596 --> 00:09:10,676
Speaker 1: South Dakota and North Dakota, West Virginia, Alaska. For sure.

174
00:09:11,196 --> 00:09:13,556
Speaker 1: I think that we've been able to really build on

175
00:09:13,596 --> 00:09:16,196
Speaker 1: our community partnerships and community strengths, and I think that

176
00:09:16,196 --> 00:09:18,356
Speaker 1: that is very helpful. And being able to get out

177
00:09:18,436 --> 00:09:21,836
Speaker 1: vaccine very very quickly. It's a whole other burden and

178
00:09:21,876 --> 00:09:24,316
Speaker 1: a huge challenge in really large urban areas. And like

179
00:09:24,316 --> 00:09:26,476
Speaker 1: I said, even here, our urban areas or sometimes are

180
00:09:26,516 --> 00:09:30,036
Speaker 1: more challenging issues. You need more technology for scheduling, you

181
00:09:30,156 --> 00:09:32,996
Speaker 1: need just to manage a lot more people. Communication becomes

182
00:09:33,076 --> 00:09:36,356
Speaker 1: much harder, while logistics is something that is easier to

183
00:09:36,396 --> 00:09:39,356
Speaker 1: overcome than some of those other barriers. So I think

184
00:09:39,356 --> 00:09:43,156
Speaker 1: that relying on partners really being able to ask communities

185
00:09:43,156 --> 00:09:45,076
Speaker 1: what makes sense for them. I think being able to

186
00:09:45,116 --> 00:09:46,756
Speaker 1: ask for help that's been a big thing for us.

187
00:09:46,756 --> 00:09:48,436
Speaker 1: We've just said, Okay, we've got this vaccine, how can

188
00:09:48,436 --> 00:09:51,276
Speaker 1: you get it out? And we've had you know, for example,

189
00:09:51,276 --> 00:09:53,276
Speaker 1: and one of our communities we're struggling to get vaccine

190
00:09:53,316 --> 00:09:56,076
Speaker 1: out and a bunch of people who had suffered opioid

191
00:09:56,076 --> 00:09:58,436
Speaker 1: addiction said we'll help, and we'll call and they help

192
00:09:58,476 --> 00:10:01,476
Speaker 1: schedule appointments and drive elders and volunteer at a site

193
00:10:01,476 --> 00:10:02,916
Speaker 1: and be able to move it forward. So it's one

194
00:10:02,916 --> 00:10:04,476
Speaker 1: of the things I really love about working in Alaska

195
00:10:04,516 --> 00:10:07,076
Speaker 1: as these community resources and efforts, But I think it's

196
00:10:07,116 --> 00:10:09,396
Speaker 1: something that we can do more of as a kind tree,

197
00:10:09,556 --> 00:10:11,876
Speaker 1: is being able to ask each other for help and

198
00:10:11,956 --> 00:10:14,516
Speaker 1: being able to rely on a diverse set of partners

199
00:10:14,836 --> 00:10:17,876
Speaker 1: to be able to do everything from vaccine distribution to

200
00:10:17,956 --> 00:10:20,636
Speaker 1: other healthcare needs so that we collectively can be more

201
00:10:20,636 --> 00:10:23,356
Speaker 1: healthy and well together and look outside of traditional partners.

202
00:10:23,356 --> 00:10:25,116
Speaker 1: It doesn't just have to be the nurse or the doctor,

203
00:10:25,236 --> 00:10:27,236
Speaker 1: or the state or the federal government to do this.

204
00:10:27,316 --> 00:10:29,916
Speaker 1: It really takes all of us. Let me ask you

205
00:10:29,916 --> 00:10:33,476
Speaker 1: a little bit about yourself. When the pandemic hit Less Spring,

206
00:10:33,476 --> 00:10:36,276
Speaker 1: you'd only been the chief medical officer for about six months.

207
00:10:37,116 --> 00:10:38,916
Speaker 1: What was it like to have to deal with such

208
00:10:38,916 --> 00:10:43,036
Speaker 1: a huge emergency so quickly? How did you how did

209
00:10:43,076 --> 00:10:46,196
Speaker 1: you begin to think about it when faced with this problem. Yeah,

210
00:10:46,196 --> 00:10:49,956
Speaker 1: so I'm a practicing emergency medicine physician as my background,

211
00:10:50,036 --> 00:10:51,996
Speaker 1: and I still see patients, so I think that I

212
00:10:52,356 --> 00:10:55,076
Speaker 1: bring that approach to whatever I do. I had an

213
00:10:55,116 --> 00:10:58,876
Speaker 1: experience early in residency that reminded me how important it

214
00:10:58,916 --> 00:11:01,116
Speaker 1: is to treat the patient first and remember that the

215
00:11:01,156 --> 00:11:03,076
Speaker 1: rest is noise, and so that's been kind of my

216
00:11:03,156 --> 00:11:07,236
Speaker 1: guiding professional philosophy throughout my entire career in medicine. I

217
00:11:07,276 --> 00:11:11,236
Speaker 1: really believe an open, honest community. We have just dozens

218
00:11:11,276 --> 00:11:13,756
Speaker 1: of these echoes where we have calls with the public

219
00:11:13,796 --> 00:11:16,916
Speaker 1: and healthcare workers and vaccine providers all across the state.

220
00:11:16,956 --> 00:11:19,876
Speaker 1: So having a lot of two way conversations really really important,

221
00:11:20,396 --> 00:11:23,116
Speaker 1: and just relying on our team. As emergency medicine doctor,

222
00:11:23,156 --> 00:11:25,996
Speaker 1: I'm not the cardiologist, I'm not the orthopedic surgeon. I'm

223
00:11:26,036 --> 00:11:28,556
Speaker 1: not the primary care doctor who knows their history. But

224
00:11:28,676 --> 00:11:31,076
Speaker 1: I'm that person in a time of crisis who helps

225
00:11:31,116 --> 00:11:34,076
Speaker 1: to connect the pieces together for one goal, and that's

226
00:11:34,076 --> 00:11:36,036
Speaker 1: the health of my patient. And I just see this

227
00:11:36,156 --> 00:11:38,716
Speaker 1: role and as a chief medical officer as an extension

228
00:11:38,756 --> 00:11:41,516
Speaker 1: of that. I'm not the epidemiologist. I'm not the infectious

229
00:11:41,556 --> 00:11:44,196
Speaker 1: disease doctor. I'm not the logistical expert. I'm just the

230
00:11:44,436 --> 00:11:46,596
Speaker 1: er doc in the center. We're really trying to figure

231
00:11:46,636 --> 00:11:48,236
Speaker 1: out what makes sense for the health and well being

232
00:11:48,276 --> 00:11:51,236
Speaker 1: of Alaskans. So in a lot of parts of the country,

233
00:11:51,316 --> 00:11:53,756
Speaker 1: I know that public health officials have faced a lot

234
00:11:53,836 --> 00:11:58,476
Speaker 1: of pushback and even personal threats. In some places, there

235
00:11:58,516 --> 00:12:00,476
Speaker 1: have been a lot of resignations. People say there's too

236
00:12:00,556 --> 00:12:03,396
Speaker 1: much political pressure from the job. Have you found any

237
00:12:03,436 --> 00:12:06,236
Speaker 1: of that in Alaska? And how have you coped with

238
00:12:06,276 --> 00:12:10,836
Speaker 1: the politicization of this crisis and the depth of anger

239
00:12:10,916 --> 00:12:12,996
Speaker 1: that people have felt about some of the restrictions that

240
00:12:12,996 --> 00:12:15,316
Speaker 1: have been placed on them. Yeah, I think this pandemic

241
00:12:15,396 --> 00:12:18,116
Speaker 1: has been hard on everyone. It's been hard on Alaskans,

242
00:12:18,156 --> 00:12:20,716
Speaker 1: It's been hard on public health officials. It's been incredibly

243
00:12:20,716 --> 00:12:23,396
Speaker 1: hard on my team, both because of political but just

244
00:12:23,516 --> 00:12:26,756
Speaker 1: because of work. It's been NonStop for you know, almost

245
00:12:26,796 --> 00:12:29,636
Speaker 1: a year now, of responding and really taking on the

246
00:12:29,676 --> 00:12:33,996
Speaker 1: responsibility of every death, of every hospitalization, of every vaccine

247
00:12:34,036 --> 00:12:36,716
Speaker 1: being distributed, and making sure that it's done as fast

248
00:12:36,716 --> 00:12:39,516
Speaker 1: and fair as we possibly can. I think again, in

249
00:12:39,556 --> 00:12:42,916
Speaker 1: the emergency department, I'm used to people being scared and

250
00:12:42,956 --> 00:12:46,556
Speaker 1: frustrated and angry, and sometimes when they are hurt or

251
00:12:46,636 --> 00:12:50,116
Speaker 1: lost or upset, that's when they lash out. And I

252
00:12:50,156 --> 00:12:52,836
Speaker 1: have found it useful to just really stay focused on

253
00:12:53,436 --> 00:12:55,916
Speaker 1: my own internal principles and what I can do for

254
00:12:55,996 --> 00:12:58,356
Speaker 1: the patient at that moment. And I think that that

255
00:12:58,516 --> 00:13:02,876
Speaker 1: clarity has been helpful despite a lot of frustration. I also,

256
00:13:02,956 --> 00:13:05,076
Speaker 1: early on the pandemic, when I was looking around to

257
00:13:05,116 --> 00:13:08,036
Speaker 1: other countries and other states, felt like when a state

258
00:13:08,076 --> 00:13:11,636
Speaker 1: could work collectively together or country could work collectively together

259
00:13:12,076 --> 00:13:15,396
Speaker 1: despite large differences of opinions, they did better, there were

260
00:13:15,436 --> 00:13:18,756
Speaker 1: less cases, there were less deaths, that COVID really takes

261
00:13:18,796 --> 00:13:20,996
Speaker 1: advantage of the cracks between us, and it was more

262
00:13:21,036 --> 00:13:25,276
Speaker 1: important to me that I work collectively than any specific policy,

263
00:13:25,476 --> 00:13:28,436
Speaker 1: any one decision, And so I don't always agree with

264
00:13:28,436 --> 00:13:30,516
Speaker 1: the governor. He doesn't always agree with me. I don't

265
00:13:30,516 --> 00:13:33,436
Speaker 1: always agree with my team, and we hash it out

266
00:13:33,516 --> 00:13:36,916
Speaker 1: together as adults and go around and around and share

267
00:13:36,956 --> 00:13:39,556
Speaker 1: our sides, and at the end of the day, try

268
00:13:39,556 --> 00:13:43,316
Speaker 1: to always make decisions collectively together because we feel like

269
00:13:43,316 --> 00:13:46,356
Speaker 1: that is more important to controlling COVID than any single

270
00:13:46,356 --> 00:13:50,036
Speaker 1: policy decision. And you do all of this while still

271
00:13:50,076 --> 00:13:53,236
Speaker 1: working occasionally as an ear doc. Is that is that

272
00:13:53,276 --> 00:13:56,036
Speaker 1: what I heard? Yeah, I still work in the emergency department.

273
00:13:56,516 --> 00:13:59,996
Speaker 1: I love it. It's helpful, it's really grounding. It's great

274
00:14:00,036 --> 00:14:03,036
Speaker 1: to solve little problem. Second, so a laceration and it

275
00:14:03,076 --> 00:14:05,436
Speaker 1: looks better, which is sometimes way easier than trying to

276
00:14:05,436 --> 00:14:08,756
Speaker 1: get vaccine out across our state. So it's rewarding in

277
00:14:08,756 --> 00:14:11,676
Speaker 1: that way. I really just love talking to people and

278
00:14:11,716 --> 00:14:14,956
Speaker 1: hearing their stories. It's this incredible gift in medicine to

279
00:14:14,996 --> 00:14:16,996
Speaker 1: be able to walk into someone's room who you've never

280
00:14:17,036 --> 00:14:19,916
Speaker 1: met and within seconds they tell you, you know, something

281
00:14:19,916 --> 00:14:22,356
Speaker 1: that's really scaring them, or something that's super concerning to them,

282
00:14:22,436 --> 00:14:24,476
Speaker 1: or they're in pain, and you're able to help them.

283
00:14:25,236 --> 00:14:28,036
Speaker 1: So I find that my work as a chief medical

284
00:14:28,076 --> 00:14:32,316
Speaker 1: officer helps me with the feeling of frustration and that

285
00:14:32,316 --> 00:14:34,036
Speaker 1: the systems are never going to change in the ear,

286
00:14:34,156 --> 00:14:36,236
Speaker 1: but working that ar helps to ground me in the

287
00:14:36,276 --> 00:14:38,316
Speaker 1: work that we're doing and the people that it's serving.

288
00:14:38,716 --> 00:14:42,236
Speaker 1: Just the complexity of how medicine presents and how it's

289
00:14:42,316 --> 00:14:45,516
Speaker 1: not all a cookbook, and how it's not all just

290
00:14:46,076 --> 00:14:48,116
Speaker 1: follow this and this is what happens. I love that

291
00:14:48,236 --> 00:14:50,236
Speaker 1: in the emergency room, and I found that I just

292
00:14:50,356 --> 00:14:53,276
Speaker 1: kept serving and making sure that what we're doing really

293
00:14:53,276 --> 00:14:55,476
Speaker 1: has meaning and that it's really working at the ground level.

294
00:14:55,556 --> 00:14:57,676
Speaker 1: So to me, they're kind of a union yang of

295
00:14:57,716 --> 00:14:59,636
Speaker 1: each other, and I couldn't do one without the other.

296
00:15:00,036 --> 00:15:03,556
Speaker 1: Sounds very much like how COVID had to be approached.

297
00:15:03,556 --> 00:15:06,636
Speaker 1: I mean, we didn't understand it at first, had unveiled

298
00:15:06,676 --> 00:15:11,436
Speaker 1: itself slowly. At each stage there have been new demands hospitalizations,

299
00:15:11,516 --> 00:15:13,636
Speaker 1: now vaccinations, and at each stage there's a lot of

300
00:15:13,676 --> 00:15:16,716
Speaker 1: mysteries that is that is that part of why you've

301
00:15:16,756 --> 00:15:20,396
Speaker 1: You've been so passionate about it. They have felt incredibly intertwined.

302
00:15:20,516 --> 00:15:23,476
Speaker 1: There's clearly huge differences between the two jobs as well,

303
00:15:24,236 --> 00:15:26,076
Speaker 1: but I find that the skills from one really have

304
00:15:26,156 --> 00:15:28,716
Speaker 1: helped with the other. We have limitations, you know, I

305
00:15:28,756 --> 00:15:31,276
Speaker 1: am not an infectious disease doctor. I've learned so much

306
00:15:31,316 --> 00:15:34,316
Speaker 1: infectious disease this past year, but I have an amazing

307
00:15:34,316 --> 00:15:36,076
Speaker 1: team that I've been able to rely on and say,

308
00:15:36,116 --> 00:15:38,636
Speaker 1: help me understand this. I'm not sure about this and

309
00:15:38,676 --> 00:15:40,716
Speaker 1: have spent a lot of my time just trying to

310
00:15:41,156 --> 00:15:44,676
Speaker 1: learn more about vaccinology or immunology, things that were not

311
00:15:44,716 --> 00:15:46,796
Speaker 1: a part of my emergency medicine world prior to this.

312
00:15:47,516 --> 00:15:50,756
Speaker 1: I don't think Alaska was originally part of your life either.

313
00:15:50,956 --> 00:15:53,476
Speaker 1: You were born in Colorado. I think where you grew

314
00:15:53,516 --> 00:15:56,796
Speaker 1: up in Colorado? What what what drew you to Alaska

315
00:15:56,916 --> 00:16:00,436
Speaker 1: and how did you become so integrated into the community

316
00:16:00,436 --> 00:16:02,676
Speaker 1: of the state. You're right, Alaska is not a part

317
00:16:02,716 --> 00:16:06,316
Speaker 1: of my plan. I you mentioned grew up in Colorado.

318
00:16:06,876 --> 00:16:10,676
Speaker 1: During college, I would spend my summers either in Wyoming

319
00:16:10,756 --> 00:16:13,196
Speaker 1: or then most of my summers actually in Alaska, working

320
00:16:13,236 --> 00:16:15,276
Speaker 1: in the mountains of Alaska. And completely fell in love

321
00:16:15,316 --> 00:16:18,316
Speaker 1: with this place. And I actually met my husband up here,

322
00:16:18,436 --> 00:16:22,796
Speaker 1: and he followed me down to residency and med school

323
00:16:23,316 --> 00:16:26,436
Speaker 1: in California, then in Utah and after that, you know,

324
00:16:26,476 --> 00:16:28,596
Speaker 1: he said, I did this seven years of med school

325
00:16:28,596 --> 00:16:30,436
Speaker 1: and residency for you. Can you do three years of

326
00:16:30,436 --> 00:16:32,916
Speaker 1: Alaska for me? I miss those mountains and I miss

327
00:16:32,956 --> 00:16:35,716
Speaker 1: being up there. I interviewed up here and took a

328
00:16:35,796 --> 00:16:39,756
Speaker 1: job in Palmer, Alaska and this kind of smallish er.

329
00:16:40,116 --> 00:16:42,436
Speaker 1: It was about as urban as he could live and

330
00:16:42,476 --> 00:16:44,756
Speaker 1: about as rural as I could work, and I just

331
00:16:44,796 --> 00:16:46,156
Speaker 1: fell in love with it. I fell in love with

332
00:16:46,156 --> 00:16:48,036
Speaker 1: the medicine. I fell in love with the people. I

333
00:16:48,076 --> 00:16:50,116
Speaker 1: fell in love with the community trying to figure out

334
00:16:50,156 --> 00:16:54,036
Speaker 1: solutions together. And I am the sort of person who

335
00:16:54,476 --> 00:16:56,516
Speaker 1: keeps asking like, well, why not and how about this?

336
00:16:56,596 --> 00:16:59,236
Speaker 1: And can't we make this better? And one meeting after

337
00:16:59,276 --> 00:17:02,676
Speaker 1: another led to multiple meetings and ultimately led to me

338
00:17:02,796 --> 00:17:05,876
Speaker 1: having this job. And predecessor took the job as the

339
00:17:05,876 --> 00:17:09,916
Speaker 1: deputy director at the CDC over infectious disease, and he's

340
00:17:09,916 --> 00:17:13,036
Speaker 1: been a great mentor through this as well. So Doctor Zinc,

341
00:17:13,516 --> 00:17:16,116
Speaker 1: we like to end all of our episodes by offering

342
00:17:16,196 --> 00:17:20,116
Speaker 1: suggestions to listeners, giving them ways they can be help

343
00:17:20,156 --> 00:17:23,636
Speaker 1: they can help, and solving problems as well. What can

344
00:17:23,676 --> 00:17:28,476
Speaker 1: people do to better support the delivery of vaccines and

345
00:17:28,516 --> 00:17:32,476
Speaker 1: the rural communities in their states? Lean in, get involved.

346
00:17:32,876 --> 00:17:34,836
Speaker 1: My husband always told me to show up for the client,

347
00:17:34,996 --> 00:17:37,116
Speaker 1: show up for your community. Ask how you can help.

348
00:17:37,516 --> 00:17:39,636
Speaker 1: Every state and every county and every community is a

349
00:17:39,676 --> 00:17:42,636
Speaker 1: little bit different. But there are lots of volunteer organizations.

350
00:17:43,116 --> 00:17:44,836
Speaker 1: You can check with Red Cross, you can check with

351
00:17:44,876 --> 00:17:47,916
Speaker 1: your local public health department. Most public health departments do

352
00:17:47,996 --> 00:17:49,916
Speaker 1: have a way for people to volunteer if you're a

353
00:17:49,956 --> 00:17:52,756
Speaker 1: licensed healthcare professional or if you're someone who wants to

354
00:17:52,796 --> 00:17:55,876
Speaker 1: volunteer to bring food or to drive people onto those areas.

355
00:17:56,356 --> 00:18:00,556
Speaker 1: I am amazed at the incredible ingenuity and problem solving

356
00:18:00,636 --> 00:18:02,676
Speaker 1: that can happen at the local level. And it might

357
00:18:02,716 --> 00:18:06,236
Speaker 1: be driving seniors to the local place to get vaccinated.

358
00:18:06,236 --> 00:18:08,556
Speaker 1: It may be helping them with the website, It may

359
00:18:08,596 --> 00:18:12,476
Speaker 1: be trying to figure out distribution and working with your community.

360
00:18:12,916 --> 00:18:15,356
Speaker 1: But there's just real power and community. So looking around

361
00:18:15,396 --> 00:18:17,916
Speaker 1: your community and looking at who's left out, who doesn't

362
00:18:17,916 --> 00:18:19,836
Speaker 1: know that it's their turn to be vaccinated. How can

363
00:18:19,876 --> 00:18:21,516
Speaker 1: you reach out to them, and how can you make

364
00:18:21,556 --> 00:18:24,796
Speaker 1: sure that they are connected, Even those little small things

365
00:18:24,836 --> 00:18:27,276
Speaker 1: that may not get a big notice. If you pick

366
00:18:27,356 --> 00:18:29,156
Speaker 1: up two or three of your friends and neighbors and

367
00:18:29,436 --> 00:18:32,156
Speaker 1: help them get vaccinated, help them work through the system,

368
00:18:32,916 --> 00:18:34,596
Speaker 1: I think that that makes a big difference. This is

369
00:18:34,636 --> 00:18:37,116
Speaker 1: a huge lift. I think so many times I just

370
00:18:37,156 --> 00:18:41,436
Speaker 1: see people waiting for someone else to do the vaccine distribution,

371
00:18:41,556 --> 00:18:43,476
Speaker 1: or waiting for someone else to figure out the problem.

372
00:18:43,956 --> 00:18:47,236
Speaker 1: We just need the ingenuity of every American helping to

373
00:18:47,236 --> 00:18:51,756
Speaker 1: solve this problem together. Everybody stepping into this space. Doctor

374
00:18:51,796 --> 00:18:54,836
Speaker 1: Ann zinc It's the chief Medical Officer of Alaska and

375
00:18:54,956 --> 00:18:58,556
Speaker 1: also an er doctor. Next week, I'm Solvable. I'm going

376
00:18:58,596 --> 00:19:00,756
Speaker 1: to sit down with my co host and Apple Bomb

377
00:19:00,996 --> 00:19:05,116
Speaker 1: for a conversation about repairing American democracy and as a

378
00:19:05,156 --> 00:19:08,796
Speaker 1: Pulitzer Prize winning historian, her most recent book is about

379
00:19:08,796 --> 00:19:12,916
Speaker 1: the eyes of authoritarianism around the world. President Joe Biden

380
00:19:12,996 --> 00:19:15,196
Speaker 1: has taken his seat in the Oval Office and our

381
00:19:15,236 --> 00:19:18,716
Speaker 1: country is deeply polarized. Ann and I will talk about

382
00:19:18,716 --> 00:19:22,076
Speaker 1: what steps might be useful to take to diminish conflict

383
00:19:22,116 --> 00:19:25,756
Speaker 1: and restore confidence in our political future. Please join us

384
00:19:26,756 --> 00:19:30,316
Speaker 1: Solvable is produced by Jocelyn Frank, research and booking by

385
00:19:30,356 --> 00:19:34,836
Speaker 1: Lisa Dunn. Our managing producer is Catherine Girardell and Pushkin's

386
00:19:34,836 --> 00:19:38,356
Speaker 1: executive producer is Mia Loebell. I'm Jacob Weisberg.