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Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's day fifty five

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Speaker 1: since coronavirus was declared a global pandemic. Our main story.

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Speaker 1: US states have started to reopen businesses, even as cases

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Speaker 1: continue to rise in some places. But a top public

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Speaker 1: health expert and former CDC director who warns there may

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Speaker 1: never be an effective vaccine, says ramping up the economy

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Speaker 1: too soon could have devastating consequences, especially for lower income people.

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Speaker 1: But first, here's what happened today. Early forecasts about the

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Speaker 1: spread of coronavirus in the US may have been to rosie.

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Speaker 1: In an NBC interview, former f DA chief Scott Gottlieb

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Speaker 1: said the country has not seen the clients and infections

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Speaker 1: that experts predicted. Gottlieb said he had expected by now

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Speaker 1: we'd see sustained declines in new cases around the country.

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Speaker 1: In fact, cases are actually increasing and around twenty states.

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Speaker 1: GOTTLEIEP is one of the advisors giving guidance on reopening

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Speaker 1: the economy to President Donald Trump, and he is also

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Speaker 1: advising several states. As the virus spreads in different countries,

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Speaker 1: it's becoming clear there's no one size fits all solution.

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Speaker 1: For containing it. In Sweden, for example, the infection rate

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Speaker 1: seems to have stabilized despite the light touch the government

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Speaker 1: has taken to locking down the country. But a team

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Speaker 1: of Goldman Sachs economists said in a note today that

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Speaker 1: we shouldn't view sweden as a model for others to

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Speaker 1: emulate the country's decision to keep schools, gyms, bars and

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Speaker 1: shops mostly open during the pandemic maybe working for him

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Speaker 1: because of uniquely Swedish demographic factors. According to Goldman, it

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Speaker 1: has a far lower population density than Italy and a

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Speaker 1: high proportion of single occupancy households. Meanwhile, in New York,

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Speaker 1: the virus death toll seems to have jumped because of

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Speaker 1: some newly revealed numbers. The state is reporting more than

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Speaker 1: seventeen hundred previously undisclosed deaths at nursing homes and adult

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Speaker 1: care facilities. New York is under scrutiny over how it

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Speaker 1: has protected vulnerable residents during the outbreak. Nearly five thousand

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Speaker 1: people have died from COVID nineteen in the state's nursing

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Speaker 1: homes since March one, according to numbers released by the

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Speaker 1: Governor's office late Monday. Exactly how many nursing home residents

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Speaker 1: have died remains uncertain despite the state's latest disclosure, as

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Speaker 1: the list doesn't include nursing home residents who were trained

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Speaker 1: asferred to hospitals before dying and now our main story.

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Speaker 1: New Jersey is one of the U S states that's

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Speaker 1: worst hit by coronavirus after New York. So when Governor

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Speaker 1: Phil Murphy looked for experts to help understand how to

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Speaker 1: provide the state's businesses safely, he tapped doctor Richard Besser.

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Speaker 1: Dr Besser was the acting director of the Centers for

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Speaker 1: Disease Control and Prevention in two thousand nine when the

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Speaker 1: H one N one swine flu pandemic broke out. He's

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Speaker 1: a physician turned epidemiologist who now runs the Robert Wood

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Speaker 1: Johnson Foundation, the philanthropic health organization. Dr Besser's expertise is

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Speaker 1: in health equality, and so he has a lot to

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Speaker 1: say about a virus that disproportionately affects communities of color

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Speaker 1: and low income people. Dr Besser talked with reporter Riley

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Speaker 1: Griffin about what happens to those most vulnerable to the

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Speaker 1: virus as states begin to relax social distancing rules. I

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Speaker 1: bring the perspective of really having learned to make decisions

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Speaker 1: during periods of incredible uncertainty. You know, what we know

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Speaker 1: about this virus is far exceeded by what we don't

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Speaker 1: know in a period of incredible uncertainty. What people want

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Speaker 1: a certainty, and that's just the one thing you can't

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Speaker 1: give them. You have to you have to be reacting

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Speaker 1: to what's going on. Uh. You know, as states try

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Speaker 1: things and start to open up parts of their economy,

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Speaker 1: do you think there could be ramifications of reopening too

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Speaker 1: early in the near future? And most importantly, who would

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Speaker 1: be most impacted by that? Well, I think that who

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Speaker 1: will who will be most impacted by that are are

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Speaker 1: the same groups who have been impacted so hard by

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Speaker 1: by the pandemic so far. When you look at at

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Speaker 1: death rates, hospitalization rates for Black Americans, Latinos, indigenous people, UM,

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Speaker 1: there are two three, even more times their representation in

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Speaker 1: the in the population UM. Low income workers tend to

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Speaker 1: get hit harder frontline workers. UM. Part of the problem

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Speaker 1: is mixed messaging. You're seeing messages that, uh, this is serious,

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Speaker 1: we all have to do our part. We have the

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Speaker 1: social distance, and then you're hearing politicians say we have

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Speaker 1: to get everyone back to work. You it's a challenge

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Speaker 1: when the messaging that we're getting, when what the public

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Speaker 1: is told to do comes more from politicians and from

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Speaker 1: public health leaders. It it at its face leads half

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Speaker 1: of the of the public to say, I'm not listening

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Speaker 1: to this person because I didn't vote for them, uh,

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Speaker 1: and others to say, yeah, I'll support them. But is

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Speaker 1: it really based on science. You want you want to

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Speaker 1: do all you can to have a response being nonpartisan,

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Speaker 1: a political and based on the best available public health science.

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Speaker 1: And you think right now the discourse is primarily a

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Speaker 1: political one. Well, it's the challenges you can't tell. You

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Speaker 1: can't tell what things are are being put forward for

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Speaker 1: politics and what things are being put forth for for science.

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Speaker 1: You know, they're The other aspect of a pandemic that

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Speaker 1: that I bring from my experience at CDC is just

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Speaker 1: a recognition that when a pandemic hits, or any new

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Speaker 1: emerging infection, it doesn't hit every community at the same

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Speaker 1: level at the same time, and so it does make

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Speaker 1: sense that different things will take place in different parts

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Speaker 1: of the country. But you want each of those things

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Speaker 1: to be best based on the best available science. And data,

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Speaker 1: and right now we're not even able to get the

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Speaker 1: data that we need because we don't have the level

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Speaker 1: of testing available. We don't have states providing data broken

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Speaker 1: down by race and ethnicity, and gender and disability and income,

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Speaker 1: so that you even have the ability to see who

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Speaker 1: in your community may be doing fine and who in

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Speaker 1: your community is really struggling. What can the government do

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Speaker 1: to alleviate some of those discrepancies at the state level

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Speaker 1: and help inform decisions that are made at the state level.

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Speaker 1: It's really important to have standards in place that protect

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Speaker 1: workers UM or those or or workers are really going

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Speaker 1: to pay the price for for that reopening. UH. What

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Speaker 1: you'd really like to see is the c d C,

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Speaker 1: through NIOSH, which is the National Institute of Occupational Safety

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Speaker 1: and Health, and OSHA, which is in the Department of Labor,

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Speaker 1: coming together to develop not voluntary standards, but mandatory standards

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Speaker 1: for for each sector. Having federal standards that can be

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Speaker 1: adopted UM and adapted locally makes a lot more sense

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Speaker 1: and leads to more trust that things are being done

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Speaker 1: based on on good science, based on principles of of

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Speaker 1: of safety first UM. Right now, it's a little challenging

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Speaker 1: to to know how all the decisions are being made.

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Speaker 1: Following two thousand nine, after you had this experience navigating

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Speaker 1: the swine flu, were there certain recommendations that you made,

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Speaker 1: UM or others made to help prepare health agencies moving

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Speaker 1: forward in anticipation of other pandemics. Well, I I left

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Speaker 1: c d C a few months into the swine flu pandemic,

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Speaker 1: and so um I wasn't there for those recommendations. But

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Speaker 1: I can tell you I I started my job as

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Speaker 1: head of emergency prepared to some response the day Katrina

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Speaker 1: hit New Orleans, and so I was very involved in

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Speaker 1: that response and very involved in the post Katrina commissions

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Speaker 1: and reports, and they all said the same thing, that

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Speaker 1: we were not prepared for a hurricane of that magnitude,

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Speaker 1: that we weren't prepared for the wide array of public

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Speaker 1: health and agencies that could hit our our country, That

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Speaker 1: we had to invest more in public health, in our

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Speaker 1: public health system, in emergency preparedness and response, and we

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Speaker 1: dropped the ball, as we have time and time again.

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Speaker 1: Drug makers are certainly already building and buying infrastructure to

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Speaker 1: be able to manufacture hundreds of millions of doses of

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Speaker 1: a vaccine. What are your personal hopes for a vaccine,

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Speaker 1: and how long do you think until we have one

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Speaker 1: easily accessible across the board for the public. You know,

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Speaker 1: I I think it's terrific that there is such a

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Speaker 1: push to develop a vaccine, to develop treatments for the

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Speaker 1: virus itself. UM. It's great that there's now an antiviral

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Speaker 1: that's showing some some effect against the coronavirus UM. When

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Speaker 1: it comes to vaccine, I worry that people assume we

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Speaker 1: definitely will have a vaccine. All of the efforts that

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Speaker 1: are going on are terrific, but there's no guarantee that

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Speaker 1: we will ever see a vaccine for coronavirus. There's quite

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Speaker 1: a number of viruses where researchers have been working for

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Speaker 1: decades and haven't been able to develop a safe and

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Speaker 1: effective vaccine. HIV, danky fever, those are two. Those are

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Speaker 1: two where the efforts have been there and they just

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Speaker 1: haven't produced something that was both safe and effective. I'm

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Speaker 1: hopeful that these efforts will pay off, but we have

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Speaker 1: to be planning for both scenarios. What do we do

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Speaker 1: to ensure that your income or the color of your

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Speaker 1: skin doesn't determine whether you get a vaccine? If you

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Speaker 1: look over history, Uh, that's been the case. And so

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Speaker 1: you know, domestically in the US, how do we ensure

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Speaker 1: that everyone has has fair access to that vaccine? And

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Speaker 1: then globally, how do we ensure that the vaccines are

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Speaker 1: not just for the wealthiest nations. I think it's much

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Speaker 1: more likely that we will see more rugs to treat

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Speaker 1: the virus in the short term, then then we'll see

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Speaker 1: a vaccine. Everybody wants to get that sense of certainty

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Speaker 1: that that you're addressing is missing. It's the first question

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Speaker 1: I get every day, and I imagine it's one you

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Speaker 1: get most frequently. What what's the timeline look like? Are

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Speaker 1: you able to provide some kind of general idea of

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Speaker 1: when you think we will return to some subblance of

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Speaker 1: normalcy or are we too far from that question? If

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Speaker 1: there isn't widespread available availability of treatment or a vaccine,

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Speaker 1: then you have to envision some form of social distancing,

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Speaker 1: uh continuing for an extended period of time. Yeah, you

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Speaker 1: know we're talking years. We're not talking months until the

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Speaker 1: virus mutates or changes or or Uh there's there is

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Speaker 1: immunity in the community, herd immunity that develops UM but

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Speaker 1: that's that sense of uncertainty that we were talking about earlier,

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Speaker 1: is it um? You know? Dr Fauci said it really

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Speaker 1: well a couple of months ago, that we don't we

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Speaker 1: don't determine the timeline here. The virus does, and we can't.

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Speaker 1: We can't fully predict what this virus will do as

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Speaker 1: the weather gets warmer over the summer. We can't predict

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Speaker 1: what will happen this fall, whether it comes back stronger,

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Speaker 1: whether it hits hard during flu season. These are things.

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Speaker 1: These are all different scenarios we need to be thinking

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Speaker 1: about planning for so that which ever one comes to fruition,

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Speaker 1: we will have done the legwork to be ready. Where

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Speaker 1: do you see the role of philanthropy right now? You know,

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Speaker 1: as as the public sector the private sector, they're looking

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Speaker 1: to expedite the drug and vaccine development process. But what

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Speaker 1: can foundations like the Robert Wood Johnson Foundation and others,

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Speaker 1: even individual philanthropists, what can they do right now? We

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Speaker 1: very quickly, we we put out some money for humanitarian

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Speaker 1: aid fifty million dollars to to target groups that were

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Speaker 1: being hit particularly hard here, uh, people of color, Indigenous people,

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Speaker 1: people with disabilities, domestic workers, groups that that we're falling

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Speaker 1: through the cracks in a lot of the federal relief

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Speaker 1: that was coming forward. Um, that's not our normal approach

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Speaker 1: humanitarian assistance. UM. We take a longer term view, and

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Speaker 1: we're working to help change how people think about health.

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Speaker 1: So it's uh, it's not just about having access to

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Speaker 1: health care. You need that, and twenty eight million people

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Speaker 1: don't have health insurance in America. But health is about

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Speaker 1: the conditions in which we live in our communities. It's

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Speaker 1: where we live and where our kids go to school,

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Speaker 1: and and where we work, and and having access to

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Speaker 1: to to high quality food in places to play. One

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Speaker 1: thing about pandemics over the course of history is that

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Speaker 1: they have frequently led to reshaping of society. So we

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Speaker 1: have the opportunity to say, what kind of America do

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Speaker 1: we want to see? Do we want an American which

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Speaker 1: people truly have have that opportunity for an American dream,

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Speaker 1: which which is is purely aspirational at this point, or

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Speaker 1: do we want to continue to have in America where

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Speaker 1: how much wealth you have, how much income, where the

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Speaker 1: color of your skin determines how long you live. That's

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Speaker 1: the way it was coming into this pandemic. I live

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Speaker 1: in Princeton, New Jersey, where life expectancy at birth is

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Speaker 1: eighty seven years. I volunteer as a pediatrician in a

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Speaker 1: clinic in Trenton, which is in the same county. It's

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Speaker 1: fourteen miles away, and children born there have a life

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Speaker 1: expectancy of seventy three years, So fourteen miles and a

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Speaker 1: fifteen year different. Fourteen year difference in life expectancy. How

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Speaker 1: can we accept that as a society. So we're working

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Speaker 1: to lift up policy changes that could make a difference,

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Speaker 1: not just during this crisis, but for the America we

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Speaker 1: believe we should have. That was Bloomberg's Riley Griffin, And

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Speaker 1: that's our show today. For coverage of the outbreak from

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Speaker 1: one bureaus around the world, visit Bloomberg dot com slash

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Speaker 1: coronavirus and if you like the show, please leave us

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Speaker 1: a review and a rating on Apple Podcasts or Spotify.

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Speaker 1: It's the best way to help more listeners find our

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Speaker 1: global reporting. The Prognosis Daily edition is hosted by me

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Speaker 1: Laura Carlson. The show is produced by Me Tophor Forehead,

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Speaker 1: Jordan goas Pure and Magnus Hendrickson. Today's main story was

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Speaker 1: reported by Riley Griffin, original music by Leo Sidrin. Our

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Speaker 1: editors are Francesca Levi and Rick Shine. Francesco Levi is

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Speaker 1: Bloomberg's head of podcasts. Thanks for listening one