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Speaker 1: Hi everyone, I'm Katie Kuric and this is Next Question.

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Speaker 1: My company, Katie Kirk Media, wouldn't get to do all

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Speaker 1: the cool things we do like bring you this podcast

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Speaker 1: if it weren't for the really innovative, smart and forward

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Speaker 1: thinking companies were lucky enough to partner with. One of

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Speaker 1: those partners is the biopharmaceutical company Murk, And on this

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Speaker 1: sponsored episode of Next Question, I'm sharing a conversation I

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Speaker 1: had with Mark's executive Vice president and Chief Patient Officer,

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Speaker 1: Dr Julie Gerberdeine. I got to know Dr Gerberdeine when

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Speaker 1: she was head of the c d C. She really

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Speaker 1: knows her stuff. We also work closely together on calling

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Speaker 1: cancer awareness back in the day. As a company with

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Speaker 1: a long legacy of research and infectious disease, Murk has

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Speaker 1: been in the thick of the COVID crisis, mobilizing its

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Speaker 1: scientific expertise to help address the pandemic. So in this conversation,

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Speaker 1: Dr Gerberdine and I look at the pandemics lasting impact

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Speaker 1: on public health and how we can better prepare for

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Speaker 1: the next one. I wanted to ask you on a

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Speaker 1: personal level, as we approach the summer of how are

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Speaker 1: you feeling cautiously optimistic. Yeah, I I believe in the

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Speaker 1: value of the vaccines, and I think we're going to

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Speaker 1: see pockets of really high protection. But I think we're

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Speaker 1: also going to see occasional hot spots. And that's the

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Speaker 1: thing that scares me the most. I know that it's

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Speaker 1: hard to even speculate about this, Dr gerbertine, but how

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Speaker 1: concerned are you about a variant that will not be

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Speaker 1: susceptible to the vaccine, Because honestly, that's what I think about,

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Speaker 1: and I'm sure that's probably one of the reasons you're

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Speaker 1: cautiously optimistic exactly right. You know, we have the virus

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Speaker 1: and the variants versus the vaccine and vigilance, and these

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Speaker 1: variants are pretty addictable surprises, but we've been seeing them

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Speaker 1: emerge even before we put the virus under vaccine pressure,

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Speaker 1: or we hope in the future more anti viral pressure.

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Speaker 1: So given the way that this particular family of viruses operates,

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Speaker 1: I think we have to be prepared for ongoing evolution,

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Speaker 1: somewhat like we see ongoing evolution of the influenza viruses

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Speaker 1: each year, and that means that we need to prepare

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Speaker 1: ourselves for the possibility that we would need to have

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Speaker 1: a two point o version of vaccine that would keep

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Speaker 1: up with the changes in the virus. Of course, that

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Speaker 1: will be complicated, and in order to really understand that,

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Speaker 1: we have to have much better global surveillance of where

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Speaker 1: the virus is and where it's going and how it's evolving.

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Speaker 1: And we're not there yet, so we've got a lot

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Speaker 1: of work to do. Is that preparation underway even as

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Speaker 1: we speak, there are a lot of efforts underway. The

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Speaker 1: scale of the monitoring of the virus variants has exploded

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Speaker 1: in the last couple of months, and that's a good thing,

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Speaker 1: but of course it's not reaching everywhere in the world.

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Speaker 1: Even in the best of circumstances, we still have large

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Speaker 1: gaps and large time delays in our ability to see

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Speaker 1: what's happening. So in a situation like that, often what

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Speaker 1: is done is you rely on what we call sentinel sites,

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Speaker 1: so strategic places where we do intensive sampling to try

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Speaker 1: to get a feeling for what's going on on a

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Speaker 1: broader population basis, and that kind of surveillance is really

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Speaker 1: was helping us track this virus across the world. Let

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Speaker 1: me ask you sort of a dumb question but if

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Speaker 1: a variant is discovered and we find that it is

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Speaker 1: not susceptible to the current vaccines, how quickly can another

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Speaker 1: vaccine be developed to deal with that? But you know,

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Speaker 1: that's the good news about some of the vaccines that

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Speaker 1: we have right now, the m R and A vaccines

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Speaker 1: in particular, it's barely easy to adjust the RNA that

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Speaker 1: is in them. So already both Baiser and Maderna are

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Speaker 1: testing the next generation of vaccines, and I think the

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Speaker 1: news is promising that we're likely to see um the

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Speaker 1: ability to keep up with the coronavirus. Of course, the

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Speaker 1: faster we bring it under control now in the largest

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Speaker 1: number of places, the less that new vaccine will be needed,

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Speaker 1: and hopefully it could be delayed. So we still want

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Speaker 1: to concentrate on getting as many people as possible vaccinated

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Speaker 1: right now and not undoing the good work that our

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Speaker 1: vigilance up to this point has accomplished. But I you know,

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Speaker 1: you can imagine a scenario between vaccines and then anti

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Speaker 1: virals where we convert what has been a tragedy around

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Speaker 1: the world into something that does seem more like influenza manageable.

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Speaker 1: Certainly don't want to get it if we can avoid it,

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Speaker 1: but nevertheless, it's not something that shuts down the economy

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Speaker 1: or causes the kind of economic and humanitarian crisis that

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Speaker 1: we're experiencing right now. From what you've seen so far,

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Speaker 1: do you think that we'll have to get a booster

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Speaker 1: every year? You know, the term booster is used in

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Speaker 1: two ways. It's used first of all, for the possibility

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Speaker 1: that the immunity from the vaccine might not lost last

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Speaker 1: very long, so you would need a booster dose to

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Speaker 1: keep your immunity as high as possible. But then there's

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Speaker 1: also this issue of variants, and that would require a

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Speaker 1: slightly different vaccine to be used, So both things could

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Speaker 1: be be true. Right now, we don't know how long

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Speaker 1: the vaccines will provide protection, even if the virus didn't

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Speaker 1: change at all, simply because they're new and we haven't

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Speaker 1: had a chance to follow people long enough to answer

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Speaker 1: that question. But I wouldn't be at all surprised if

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Speaker 1: we're going to need to see uh, what I would

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Speaker 1: call two point all vaccines. We may actually get to

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Speaker 1: the point where the content of the vaccine also balls,

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Speaker 1: so that we will be able to create longer lasting

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Speaker 1: community with a single vaccine or a broadening of the

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Speaker 1: immune effect that would cover more than one variant or

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Speaker 1: have the ability to be more universally protected for this

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Speaker 1: family of coronavirus is. So those are the things will

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Speaker 1: aim for down the road. But I think in this

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Speaker 1: pandemic the best thing that's happened is science has been

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Speaker 1: on our side in terms of the speed with which

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Speaker 1: we were able to roll out in the vaccine and

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Speaker 1: to have it have such high efficacy is nothing short

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Speaker 1: of miraculous. When you heard that the vaccine was rolling

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Speaker 1: out so quickly, Uh, were you astonished? And was there

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Speaker 1: any part of you? Dr Gerberdine that was worried? Well

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Speaker 1: before we even we're thinking about how fast would it

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Speaker 1: take to get a vaccine, we're watching what really looked

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Speaker 1: like very early and worrisome signs of person to person transmission.

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Speaker 1: And then when you started hearing these anecdotes about perhaps

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Speaker 1: asymptomatic transmission, I was extremely worried because this is almost

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Speaker 1: the you know, syndrome X kind of exercise that we've

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Speaker 1: so long prepared for, where you have something that's silently spread,

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Speaker 1: that moves very efficiently from person to person and can

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Speaker 1: cause really deadly disease. So I was extremely alarmed by

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Speaker 1: this situation, and I think many of my colleagues in

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Speaker 1: the public health system were equally concerned. You don't want

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Speaker 1: to jump out in front of something like that and

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Speaker 1: create unnecessary alarm, But at the same time, the signals

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Speaker 1: were there, and having trained in this area of my

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Speaker 1: whole life, I was on the alert, and I was

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Speaker 1: obviously very disappointed to find out that those concerns were

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Speaker 1: well founded. But what about Was there any part of

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Speaker 1: you that was worried about the vaccine being produced so

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Speaker 1: quickly that, um, you know, I think a lot of

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Speaker 1: people were so thrilled about it, but I think simultaneously

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Speaker 1: there was a lot of worry in the general public. Well, gosh,

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Speaker 1: that's sort of quick, and maybe it won't work because

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Speaker 1: it was developed so quickly. You know. There's a couple

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Speaker 1: of things that a lot of people haven't really been

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Speaker 1: I'm told, and that is that the work on this

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Speaker 1: class of vaccines and this family of viruses had been

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Speaker 1: going on for a long time before this particular coronavirus emerged.

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Speaker 1: We've seen two other coronavirus is the Stars in two

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Speaker 1: thousand and three and the Mirrors that has been percolating

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Speaker 1: along in the Middle East for quite some time, so

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Speaker 1: work on coronavirus vaccines have been going on in the background,

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Speaker 1: and a lot of the important steps of developing a

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Speaker 1: vaccine had already been accomplished. That's part of the reason

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Speaker 1: why we're able to jump on this so quickly and

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Speaker 1: more or less sub atitude in the specifics of this

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Speaker 1: coronavirus into the platforms in the backbone of the work

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Speaker 1: that had already been done. But I don't think that

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Speaker 1: story was really completely told, and so people have the

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Speaker 1: impression that we had nothing and then all of a

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Speaker 1: sudden we had a fully formed vaccine, and that does

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Speaker 1: seem very fast, and I think the emphasis on how

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Speaker 1: quickly we could get people vaccinated did make people worry

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Speaker 1: about the safety. Now, one of the things that I'm

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Speaker 1: proud of the pharmaceutical industry for is that we stood

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Speaker 1: strong with the f d A and said, we want

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Speaker 1: person of all clarity on what the requirements for approval are,

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Speaker 1: but also we will not take safety shortcuts. And we

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Speaker 1: all step forward and signed a pledge to that effect

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Speaker 1: that even though we knew how important it was to

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Speaker 1: get an authorized vaccine as quickly as possible. We pledged

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Speaker 1: no safety shortcuts, and we wanted to make sure that

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Speaker 1: when the pandemic vaccines went through the regulatory of a

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Speaker 1: process that they were subject to the same high standard

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Speaker 1: that we use for all of the other vaccines that

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Speaker 1: we've made. And I feel really proud of that, and

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Speaker 1: that gives me a lot of confidence. It doesn't mean

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Speaker 1: that there isn't a side effect or that there couldn't

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Speaker 1: be a problem down the road, but we're using high

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Speaker 1: standards and we're watching and reporting what we do see.

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Speaker 1: Is it disconcerting that one in three Americans say they

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Speaker 1: will not get vaccinated according to a recent poll. You know,

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Speaker 1: vaccine hesitancy was a problem a year before this pandemic

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Speaker 1: even was known. Um w h O cited Vaccine hesitancy

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Speaker 1: is when the top ten health challenges in the world

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Speaker 1: in two thousand and nineteen. So it's a problem in

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Speaker 1: our society. Part of the problem is just broad mistrust

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Speaker 1: in science. Part of the problem is mistrust in the

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Speaker 1: people who are providing information and making those kinds of recommendations.

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Speaker 1: And then there's a whole host of other reasons that

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Speaker 1: may nothing to do with vaccines but have to do

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Speaker 1: with the social context in which people make their health

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Speaker 1: decisions and their trust of government or trust of the

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Speaker 1: health system more broadly. So it's been a very important

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Speaker 1: problem for a long time. Now you bring a pandemic

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Speaker 1: into it, and then you bring forward something new and

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Speaker 1: new approaches to vaccinology that people haven't been familiar with,

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Speaker 1: so it's understandable that there would be some spectrum of hesitancy. Um.

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Speaker 1: You know, we've been vaccine a lot of people now.

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Speaker 1: I think almost two billion doses of vaccine have been

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Speaker 1: administered around the world, so we know a lot more

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Speaker 1: now than we did in January. I think that's helping

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Speaker 1: some people feel like, Okay, you know, we've watched, we've learned, Um,

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Speaker 1: I'm ready. But there still is a sizeable proportion of

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Speaker 1: our population who, for whatever reason, doesn't feel that vaccine

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Speaker 1: is the right decision for them. And I am worried

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Speaker 1: about that because I think our hopes of herd immunity

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Speaker 1: UM being achieved are dwindling if we don't get a

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Speaker 1: high enough coverage of our population to really quench those

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Speaker 1: last um, those last arms that aren't protected. So I

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Speaker 1: really worry that we're going to have pandemic fatigue, and

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Speaker 1: that as we head into a situation where it looks

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Speaker 1: very promising in the short run, if we're not vigilant,

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Speaker 1: and if we go too far in terms of opening up,

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Speaker 1: our society will be right back where we started. We'll

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Speaker 1: take a quick break, but when we come back, what

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Speaker 1: exactly is herd immunity and why is it so critical?

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Speaker 1: That's right after this, Why is her immunity so important?

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Speaker 1: I know, and maybe you could explain it to an

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Speaker 1: eighth grader what herd immunity is and what percentage of

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Speaker 1: the population needs to be vaccinated and why it's so

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Speaker 1: critical and in stay being off kind of an up

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Speaker 1: uptick in the numbers. You know, when you think about

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Speaker 1: how viruses moved, they moved from someone who has it

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Speaker 1: to someone who doesn't. But if the person that you're

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Speaker 1: in contact with is immune to the virus, it's a

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Speaker 1: dead end for them. So the more dead ends there

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Speaker 1: are in a community, the less likely it is that

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Speaker 1: any infected person will be able to transmit the virus. Now,

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Speaker 1: you don't have to have a hundred percent coverage in

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Speaker 1: order for that to happen, but the amount that is

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Speaker 1: necessary really depends on how infectious the virus is. Let's

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Speaker 1: say you're dealing with measles. Measles is much more transmissible

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Speaker 1: even than stars COVID two. So for measles, in order

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Speaker 1: to make sure that a case of measles does not

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Speaker 1: spread out into the small population of uninfected people, you

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Speaker 1: have to have at least of people vaccinated, and some

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Speaker 1: people would say the number needs to be much higher

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Speaker 1: than that because measles is so transmissible. Um some other

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Speaker 1: infectious diseases are much less transmissible, and you don't need

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Speaker 1: such high coverage in order to find the dead ends

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Speaker 1: because even if you came in contact with someone who

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Speaker 1: wasn't immune, they still might not have a chance of

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Speaker 1: getting it from you because it just isn't that easy

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Speaker 1: to catch. So where we are with ours KOPE two

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Speaker 1: is first of what, we don't know exactly how much

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Speaker 1: population protection we need, but we know we're not there

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Speaker 1: yet and that's obvious just by looking at the ongoing

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Speaker 1: spread of cases. Unfortunately, that immunity, given the world we

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Speaker 1: live in, can't just be one community or one state

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Speaker 1: or one nation. We have to really be thinking about

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Speaker 1: how do we protect the world, and that's a challenge

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Speaker 1: we've never saw for before. So it's daunting, and I

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Speaker 1: think we recognize that it's going to take us a

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Speaker 1: long time to get there. In the US, what percentage

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Speaker 1: ideally would you like to see to achieve her immunity,

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Speaker 1: understanding that we're not really quite sure of the exact

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Speaker 1: number yet, you know, for the United States as a whole. Again,

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Speaker 1: I'm just taking a guest here. I don't think anyone

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Speaker 1: knows the answer to that, but at least sev I

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Speaker 1: think at least sevent And I say that knowing that

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Speaker 1: even in a vaccinated population, there will still be people

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Speaker 1: who are pretty vigilant. So you're kind of adding masks

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Speaker 1: and other measures that some of us will be less

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Speaker 1: likely to give up anytime soon, so that we'll have

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Speaker 1: some surround sound of protection which also contributes to the

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Speaker 1: dead end of transmission that I was talking about earlier. Um,

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Speaker 1: but you know, that number could be higher than we need.

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Speaker 1: It could also mean that the number needs to be

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Speaker 1: much higher to really bring this under containment. And I

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Speaker 1: also worry because we've seen that the stars the two

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Speaker 1: virus can move into animal populations, for example, minx and

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Speaker 1: ferrets other animals, so there could be a reservoir where

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Speaker 1: the virus hides out away from the human population, but

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Speaker 1: could spill back over again um into unprotected people, or

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Speaker 1: a variant of the virus could spill back over. So

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Speaker 1: I don't think we're in a position where we can

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Speaker 1: think about eradicating this virus. UM. We certainly should aim

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Speaker 1: to contain it, and if we're really lucky, we can

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Speaker 1: eliminate it from large partial parts of the population, but

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Speaker 1: lots of work to go between where we are now

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Speaker 1: at that point. Some Black Americans are hesitant, as you

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Speaker 1: well know, to get the vaccine. Uh. There has been

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Speaker 1: a dark chapter in medical history with the Tuskegee experiment,

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Speaker 1: for example, and some of the medical procedures that were

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Speaker 1: tested on enslaved women. Uh and people in general. Have

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Speaker 1: we done enough to reach out to the black community

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Speaker 1: to allay their fears of this vaccine. No, we haven't

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Speaker 1: done enough, And I'm not sure what it will take

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Speaker 1: to really regain that kind of trust and medical science

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Speaker 1: the government agencies that participated in that experiment so many

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Speaker 1: decades ago. UM. But it's real and it's generational that

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Speaker 1: mistrust is transmitted from one generation to another, but is

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Speaker 1: compounded by all of the other things that create health

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Speaker 1: disparities in our society and these days political disparities in

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Speaker 1: our society. So UM, we have to think about that

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Speaker 1: in the broader issue of health equity and social justice,

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Speaker 1: because these things all work in kind of an integrated

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Speaker 1: way to influence people's broad trust in their government and

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Speaker 1: in their government decision makers. So I wish we could

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Speaker 1: do more. I think one of the things that I

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Speaker 1: believe is that it's not really about giving people more

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Speaker 1: facts or figures. It's about recognizing the true feelings and

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Speaker 1: perspectives they have, and it's about helping the people who

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Speaker 1: they do trust be good messengers and communicators about how

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Speaker 1: the decision can be made. What information is helpful, Listening

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Speaker 1: to people's worries and concerns and really validating them, um,

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Speaker 1: not trying to talk them out of their concerns, but

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Speaker 1: rather recognizing this is their reality, and we want to

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Speaker 1: be helpful. We want to give the right information, but

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Speaker 1: that information is probably best coming from people that they

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Speaker 1: already trust, and usually that's not the government. And to

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Speaker 1: bring more people of color into the medical community so

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Speaker 1: the individuals they're interfacing with, uh look more like them

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Speaker 1: and can appreciate sort of where they're coming from. Yeah,

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Speaker 1: that I think that's really important. One of the things

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Speaker 1: that kind of behind the scenes that's happened UM in

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Speaker 1: the course of the vaccine development and in my company

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Speaker 1: we're working on an anti viral or stars KVI two,

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Speaker 1: and that is that we are really doubling down and

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Speaker 1: trying to do exactly what you said, work with the

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Speaker 1: medical leaders from the communities of color, but also UM

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Speaker 1: preferentially work harder to enroll and encourage people in those

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Speaker 1: communities to participate in the clinical trials, but also to

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Speaker 1: understand their value and the importance of broadening the diversity

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Speaker 1: of what we're doing. So if you look at the

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Speaker 1: statistics about who participated in the vaccine trials, it looks

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Speaker 1: very different than the clinical trials that we normally conducts.

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Speaker 1: I think there's been some real important learning there. Hopefully

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Speaker 1: we can build on that going forward when we come

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Speaker 1: back a c after covid, are we actually better protected

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Speaker 1: for this coming age of pandemics that's right after this

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Speaker 1: and the continuing battle Dr Gerberdine against uh COVID nineteen.

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Speaker 1: NIH director Francis Collins has stressed the importance of developing

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Speaker 1: new drug therapies. Dr Fauci has said this is the

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Speaker 1: age of pandemics, so COVID nineteen or some iteration of

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Speaker 1: it is likely to be with us for a very

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Speaker 1: long time. Tell me a little bit about the work

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Speaker 1: MRK is doing to address those concerns. Thank you for

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Speaker 1: putting this in the long term context, Katie, because you know,

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Speaker 1: I am a firm believer that this isn't a one

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Speaker 1: off thing that just happened to us, this pandemic. I

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Speaker 1: truly believe that we will see this happen again. Emergence

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Speaker 1: is part of the cultural and global milieu that we

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Speaker 1: live in. All of our travel, our connectivity with animals, urbanization,

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Speaker 1: climate change, all of these things have created a cauldron

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Speaker 1: where infectious diseases are going to emerge and spread much

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Speaker 1: more quickly than they did a hundred years ago. So

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Speaker 1: that's our reality. And if you're a part of the

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Speaker 1: biopharmaceutical industry in that reality, it's part of your responsibility

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Speaker 1: to figure out how are we going to adjust our

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Speaker 1: portfolio in our platform so that we continue to be

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Speaker 1: able to help with the most pressing human health problems

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Speaker 1: that emerge. So, yes, we're all thinking about biosecurity in

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Speaker 1: a very different framework. I also think that our government

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Speaker 1: needs to think differently about how we approach these things.

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Speaker 1: This isn't just a public health problem. This is a

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Speaker 1: national security problem in every country because it creates destabilization,

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Speaker 1: social rest, economic hardship. It's a it's a nightmare, and

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Speaker 1: we have to be willing to plan for and invest

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Speaker 1: in a very different order of magnitude and how we

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Speaker 1: approach the problem. So, for example, right now, our model

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Speaker 1: is trying to figure out where something has emerged, try

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Speaker 1: to contain it there, and if that doesn't work, then

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Speaker 1: go into all of the things that we're doing right

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Speaker 1: now with vigilance and vaccines, etcetera, etcetera. What would it

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Speaker 1: be like if instead of waiting until something happens and

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Speaker 1: then trying to jump on it, we actually win upstream

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Speaker 1: and thought about, now, how can we understand and predict

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Speaker 1: where something like this will happen. We're the most likely

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Speaker 1: places for a new virus to emerge, what families of

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Speaker 1: viruses are most likely to emerge? Can we create with

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Speaker 1: our science today much more early stage vaccines and anti

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Speaker 1: virals in the freezer so that if one of these

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Speaker 1: pathogens or families of pathogens do start to cause a problem,

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Speaker 1: we can act faster and be really much more prepared

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Speaker 1: than we were for this one. So that's really a frameshift.

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Speaker 1: And we've talked about this before, We've talked about this

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Speaker 1: broadly for a long period of time. I'm hoping that

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Speaker 1: this pandemic is so bad that finally we will really

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Speaker 1: get serious about how we invest in biosecurity. Never again

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Speaker 1: should we have to deal with the kind of crisis

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Speaker 1: that we have today. Do you see things moving in

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Speaker 1: that direction, that kind of preparedness, because of course there's

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Speaker 1: been so many people finger pointing that we were unprepared

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Speaker 1: for this pandemic, and I'm curious if a you agree

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Speaker 1: with that and be if you think now things will

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Speaker 1: change and the infrastructure and the resources required to track

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Speaker 1: these emerging viruses will be put in place. That is

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Speaker 1: a really hard question, Katie. I would love to say, yes,

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Speaker 1: we've learned our lesson. The conversation that I have with

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Speaker 1: our senators and members of Congress really indicate to me

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Speaker 1: that they're deeply concerned and they're willing to invest in

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Speaker 1: the crisis resolution. But I've been here and done this before.

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Speaker 1: In fact, I co chair the c S I S

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Speaker 1: Commission on Global Health Security, and our report that came

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Speaker 1: out before the pandemic started was entitled from Crisis to Complacency.

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Speaker 1: We have to end the cycle. So when something happens,

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Speaker 1: we have an emergency response, we get emergency resources, we

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Speaker 1: do an after action review, we list all the things

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Speaker 1: we need to do to be better prepared. But when

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Speaker 1: the crisis goes away, all of that investment goes away

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Speaker 1: and we go back to kind of our complacent state.

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Speaker 1: So I am working as hard as I can to

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Speaker 1: be an ambassador for a true UH strategic change in

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Speaker 1: how we concentrate on long term biosecurity preparedness so that

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Speaker 1: we can be much better prepared than we were for

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Speaker 1: this for this event. Does Subiden administration seem receptive to that?

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Speaker 1: You know, my reading of what I'm hearing from the

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Speaker 1: President as well as from the administration officials is absolutely

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Speaker 1: his advocacy for UM, the support for the vaccine program,

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Speaker 1: investing heavily to try to accelerate immunization and so forth.

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Speaker 1: So I think, in terms of managing where we are today,

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Speaker 1: really good signals. But the hard part will be again

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Speaker 1: as we move more into the economic recovery phase. Will

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Speaker 1: we have the investments, Will we have support from the administration,

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Speaker 1: but will we also have some bilateral, bipartisan support. UM

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Speaker 1: to really recognize that we need to think about this

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Speaker 1: in the same way we think about our Department of

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Speaker 1: Defense budget. We invest We hope that some of these

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Speaker 1: tools that we invest in we never have to use,

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Speaker 1: but if we do, we have them. And in the

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Speaker 1: case of biosecurity, we're not talking about warships or fighter planes.

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Speaker 1: We're talking about vaccines, anti virals, in a modernized surveillance system.

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Speaker 1: And I think that's certainly something that everyone could get

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Speaker 1: behind if they really understood that. UM. We have to

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Speaker 1: maintain the same kind of pasture on this that we

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Speaker 1: do when we're thinking about our national defense. And it's

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Speaker 1: not just the US. We've also learned that one country

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Speaker 1: can't do this, a set of allies can't do this.

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Speaker 1: We need to be much more globally engaged because we

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Speaker 1: are all in this together. You. Of course, we're the

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Speaker 1: head of the CDC, the Centers for Disease Control UH

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Speaker 1: a while ago, and it seems like the c d

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Speaker 1: C kind of had a lot of issues. I think

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Speaker 1: it's safe to say, dealing with this pandemic, and I'm

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Speaker 1: curious to get your view on what happened. Where do

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Speaker 1: you think the c d C UH, which you once

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Speaker 1: ran UH succeeded and failed when it came to dealing

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Speaker 1: with this pandemic and what were the lessons learned. Let

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Speaker 1: me start with some of the successes that haven't really

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Speaker 1: been recognized or discussed. UM. The support that CDC has

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Speaker 1: given at the state and local level is extraordinary. The

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Speaker 1: number of CDC experts who have been deployed to communities

434
00:27:47,119 --> 00:27:50,200
Speaker 1: to be helpful with things like communization programs and so

435
00:27:50,320 --> 00:27:53,520
Speaker 1: forth behind the scenes. That that work is still going on.

436
00:27:54,400 --> 00:27:59,320
Speaker 1: UM countless web postings, guidance documents, etcetera, etcetera. So a

437
00:27:59,359 --> 00:28:02,719
Speaker 1: lot of really outstanding public health work is supported at

438
00:28:02,760 --> 00:28:05,000
Speaker 1: the CDC, and I think they should take some pride

439
00:28:05,000 --> 00:28:08,680
Speaker 1: in that. But having said that, I think there's three issues,

440
00:28:09,119 --> 00:28:11,600
Speaker 1: UM that need to be looked at. When is some

441
00:28:11,880 --> 00:28:16,080
Speaker 1: actual performance problems and we know that early in the pandemic,

442
00:28:16,119 --> 00:28:19,680
Speaker 1: when there was problems getting reliable testing at the time

443
00:28:19,720 --> 00:28:22,400
Speaker 1: when we probably really needed it the most. So I'm

444
00:28:22,520 --> 00:28:24,760
Speaker 1: going too you know the why of that. But I

445
00:28:24,800 --> 00:28:28,760
Speaker 1: think acknowledging that and making that a priority for correction

446
00:28:28,920 --> 00:28:33,000
Speaker 1: and remediation, obviously, as I'm sure on the front burner

447
00:28:33,040 --> 00:28:36,639
Speaker 1: of everyone at the agency. The second issue really has

448
00:28:36,720 --> 00:28:40,280
Speaker 1: to do with the fact that the crisis and complacency

449
00:28:40,320 --> 00:28:44,640
Speaker 1: cycle I mentioned earlier results in the CDC's budget for

450
00:28:44,840 --> 00:28:49,040
Speaker 1: preparedness being woefully undersupported in the years when we're not

451
00:28:49,120 --> 00:28:52,640
Speaker 1: in the middle of a crisis, and so they rev

452
00:28:52,800 --> 00:28:56,520
Speaker 1: up in the in the outbreak situation. But you know,

453
00:28:56,560 --> 00:29:00,240
Speaker 1: you can't hire people on a one time budget. You

454
00:29:00,280 --> 00:29:03,560
Speaker 1: have to have sustained investment to keep people working and

455
00:29:03,600 --> 00:29:07,320
Speaker 1: to really build that preparedness. So there are structural issues

456
00:29:07,400 --> 00:29:10,000
Speaker 1: with the way the CDC has spunded that really have

457
00:29:10,160 --> 00:29:14,120
Speaker 1: to be addressed. And then finally, I think there is politics,

458
00:29:14,480 --> 00:29:17,360
Speaker 1: and I wasn't there. I don't know all the pushes

459
00:29:17,360 --> 00:29:21,320
Speaker 1: and pulls on that. But from the outside looking in, UM,

460
00:29:21,360 --> 00:29:24,640
Speaker 1: I know the competency of the scientists at the CDC,

461
00:29:25,040 --> 00:29:27,640
Speaker 1: and I was not seeing them, I was not hearing

462
00:29:27,720 --> 00:29:31,000
Speaker 1: from them, and I was listening to other people, often

463
00:29:31,320 --> 00:29:35,800
Speaker 1: people with much less public health experience or public health knowledge, UM,

464
00:29:35,840 --> 00:29:39,280
Speaker 1: and that scared me more than anything. So I do

465
00:29:39,400 --> 00:29:43,760
Speaker 1: think that the politicalization of the science and some of

466
00:29:43,800 --> 00:29:47,840
Speaker 1: the allegations that have come forward about altering documents and

467
00:29:47,880 --> 00:29:51,040
Speaker 1: so on and so forth. Those are very serious issues

468
00:29:51,200 --> 00:29:54,600
Speaker 1: and they need to be fully investigated and remediated if

469
00:29:54,600 --> 00:29:57,360
Speaker 1: they proved to be accurate. Is there a way to

470
00:29:57,400 --> 00:30:01,240
Speaker 1: prevent that from happening again in terms of who the

471
00:30:01,320 --> 00:30:05,960
Speaker 1: CDC answers to and the power of say a president

472
00:30:06,400 --> 00:30:11,680
Speaker 1: over it as an institution. You know, the truth is

473
00:30:11,760 --> 00:30:15,160
Speaker 1: that we have been exploring, in a lot of ways, um,

474
00:30:15,680 --> 00:30:20,480
Speaker 1: the traditional model of trusting that people will behave in

475
00:30:20,480 --> 00:30:23,960
Speaker 1: a certain way or follow sort of a certain paradigm

476
00:30:24,000 --> 00:30:29,120
Speaker 1: of engagement scientifically or otherwise. We we've just followed kind

477
00:30:29,160 --> 00:30:32,640
Speaker 1: of that pattern, and what we've learned is that isn't enough.

478
00:30:33,080 --> 00:30:36,280
Speaker 1: We need to have much longer guard rails and probably

479
00:30:36,360 --> 00:30:39,720
Speaker 1: some structural changes um that do need to be considered.

480
00:30:39,760 --> 00:30:42,200
Speaker 1: And I hope that when the after action review of

481
00:30:42,240 --> 00:30:46,600
Speaker 1: this entire pandemic is accomplished, that people will get really

482
00:30:46,680 --> 00:30:51,160
Speaker 1: serious about these underlying financial and structural issues. UM. We

483
00:30:51,200 --> 00:30:53,840
Speaker 1: need to look at other models for how our scientific

484
00:30:53,920 --> 00:30:58,720
Speaker 1: agencies operate. UM. And I'm you know, at the administration

485
00:30:58,760 --> 00:31:03,640
Speaker 1: of our government is political administration. Always has been, always

486
00:31:03,680 --> 00:31:06,880
Speaker 1: will be. But our science agencies also need to be

487
00:31:06,960 --> 00:31:10,520
Speaker 1: able to bring truth to those settings in ways that

488
00:31:10,640 --> 00:31:13,560
Speaker 1: help inform If you don't have a good science, you

489
00:31:13,600 --> 00:31:17,720
Speaker 1: won't ever have good policy along those lines. It's been

490
00:31:17,800 --> 00:31:21,800
Speaker 1: reassuring for me as an American citizen to see faith

491
00:31:21,840 --> 00:31:26,200
Speaker 1: in science has been at least somewhat restored, because I

492
00:31:26,240 --> 00:31:31,160
Speaker 1: was really worried and concerned about people who were really

493
00:31:31,440 --> 00:31:36,920
Speaker 1: mistrusting science and facts and information. Are you heartened by

494
00:31:36,960 --> 00:31:41,720
Speaker 1: the fact that people seem to beach fusting science more?

495
00:31:41,840 --> 00:31:45,520
Speaker 1: At least it's it's on the increase that level of

496
00:31:45,560 --> 00:31:50,240
Speaker 1: trust after declining honestly for quite some time. Yeah, I am.

497
00:31:50,360 --> 00:31:54,200
Speaker 1: I am heartened. Um, And I think it's just, um,

498
00:31:54,800 --> 00:31:57,479
Speaker 1: we're so fortunate that science has been on our side

499
00:31:57,640 --> 00:32:00,080
Speaker 1: and in the context of what needed to be, not

500
00:32:00,080 --> 00:32:03,080
Speaker 1: not just in terms of vaccines and immuno logics and

501
00:32:03,120 --> 00:32:06,240
Speaker 1: anti virals, but also more broadly in terms of our

502
00:32:06,320 --> 00:32:09,880
Speaker 1: ability to get information and share information and so forth.

503
00:32:10,240 --> 00:32:14,800
Speaker 1: So that surely should help people understand the importance of

504
00:32:14,840 --> 00:32:19,440
Speaker 1: having a robust biopharmaceutical industry or a robust health technology

505
00:32:19,600 --> 00:32:25,320
Speaker 1: capability at the same time underpinning confidence in science is

506
00:32:25,360 --> 00:32:29,600
Speaker 1: scientific literacy. And one of the things that worries me

507
00:32:29,760 --> 00:32:34,719
Speaker 1: is when science is complicated, or when communicators make it

508
00:32:34,760 --> 00:32:39,560
Speaker 1: seem really complicated. Um, people aren't able to follow it,

509
00:32:39,760 --> 00:32:43,760
Speaker 1: and so with they get confused, or if they hear

510
00:32:43,880 --> 00:32:47,800
Speaker 1: too scientists arguing with each other in a public environment,

511
00:32:48,160 --> 00:32:51,040
Speaker 1: they don't know who to believe, and because it is

512
00:32:51,120 --> 00:32:54,600
Speaker 1: technically fairly complicated, they just sort of resort too, Well,

513
00:32:54,720 --> 00:32:57,880
Speaker 1: I'm not a scientist, I can't figure this out. I'm

514
00:32:57,880 --> 00:33:02,200
Speaker 1: going to listen to my peers, who usually aren't scientists,

515
00:33:02,400 --> 00:33:04,880
Speaker 1: and so you end up in an echo chamber where

516
00:33:04,880 --> 00:33:07,800
Speaker 1: you're listening to people who might not have the right information.

517
00:33:08,160 --> 00:33:10,800
Speaker 1: And then you, you know, have to believe something, so

518
00:33:10,920 --> 00:33:14,080
Speaker 1: you tend to participate in that and it becomes truth.

519
00:33:14,720 --> 00:33:18,480
Speaker 1: So in the confidence in science moment that we're in,

520
00:33:18,880 --> 00:33:21,680
Speaker 1: I think we're at the same time experiencing a lot

521
00:33:21,800 --> 00:33:27,520
Speaker 1: of disinformation and a lot of misinformation about vaccines and

522
00:33:27,560 --> 00:33:29,800
Speaker 1: the pandemic and the causes of it and so on

523
00:33:29,800 --> 00:33:32,560
Speaker 1: and so forth. So it's it's sort of this unusual

524
00:33:32,640 --> 00:33:35,360
Speaker 1: moment in time where we have extremes on both sides

525
00:33:35,400 --> 00:33:39,680
Speaker 1: of the picture. Um. So those people like you who

526
00:33:39,680 --> 00:33:44,040
Speaker 1: are really good at communicating science to non scientists. Are

527
00:33:44,080 --> 00:33:47,080
Speaker 1: just so important in the context of this to really

528
00:33:47,720 --> 00:33:50,480
Speaker 1: um not just site facts and figures, but to really

529
00:33:50,480 --> 00:33:53,120
Speaker 1: get out there and put things into context so people

530
00:33:53,160 --> 00:33:55,360
Speaker 1: can kind of step back and say, oh, yeah, that

531
00:33:55,520 --> 00:33:58,000
Speaker 1: is kind of a miracle that we have these vaccines,

532
00:33:58,120 --> 00:34:00,800
Speaker 1: and it is kind of a miracle that the senior

533
00:34:00,840 --> 00:34:04,200
Speaker 1: citizens in the United States are seeing a dramatic decline

534
00:34:04,240 --> 00:34:07,280
Speaker 1: in death from this pandemic because of those vaccines. So

535
00:34:07,680 --> 00:34:10,480
Speaker 1: that's something we should not lose sight of. Do you

536
00:34:10,520 --> 00:34:15,399
Speaker 1: think people's impressions of pharmaceutical companies have also changed as

537
00:34:15,400 --> 00:34:19,400
Speaker 1: a result of the pandemic? And what do you think

538
00:34:19,960 --> 00:34:23,680
Speaker 1: has been a shift in mindset for big companies like

539
00:34:23,800 --> 00:34:26,840
Speaker 1: merk or J and J or you know a host

540
00:34:26,920 --> 00:34:31,680
Speaker 1: of others that visor for example, that are working really

541
00:34:31,760 --> 00:34:36,960
Speaker 1: tirelessly to try to keep Americans protected. Now we say,

542
00:34:37,200 --> 00:34:40,120
Speaker 1: you know, behind the doors of Mark, this is our

543
00:34:40,160 --> 00:34:44,280
Speaker 1: finest moment, because this is a situation where the whole

544
00:34:44,520 --> 00:34:49,279
Speaker 1: biopharmaceutical industry and the academic scientists and governments and a

545
00:34:49,280 --> 00:34:52,040
Speaker 1: lot of other people have just really collaborated in a

546
00:34:52,120 --> 00:34:56,279
Speaker 1: way that didn't just happen because we're worried about the pandemic.

547
00:34:56,600 --> 00:35:00,920
Speaker 1: It happened because it's consonant with our proven This is

548
00:35:00,960 --> 00:35:04,120
Speaker 1: why we do what we do. We love to solve

549
00:35:04,200 --> 00:35:08,520
Speaker 1: important human health problems, and we've never faced one's quite

550
00:35:08,560 --> 00:35:11,799
Speaker 1: this challenging. So it really brings out the best of

551
00:35:11,920 --> 00:35:16,040
Speaker 1: the innovation that the industries can create. But it also

552
00:35:16,120 --> 00:35:18,799
Speaker 1: brings out the best in each one of us who

553
00:35:18,880 --> 00:35:22,719
Speaker 1: really actually care deeply about what our contribution is. And

554
00:35:22,760 --> 00:35:26,120
Speaker 1: I think when you kind of marry those two things together,

555
00:35:26,320 --> 00:35:32,120
Speaker 1: you end up with the spirit of urgency, amazing collaboration,

556
00:35:33,320 --> 00:35:36,719
Speaker 1: sharing of resources that we probably would never have considered

557
00:35:36,800 --> 00:35:40,319
Speaker 1: under normal times. You know that Murk is manufacturing the

558
00:35:40,400 --> 00:35:45,240
Speaker 1: vaccine that J and j invented. Um, we we didn't

559
00:35:45,280 --> 00:35:47,279
Speaker 1: have to do that, but we thought it was the

560
00:35:47,360 --> 00:35:50,959
Speaker 1: right thing to do. We're experts at vaccine manufacturing. Jane

561
00:35:51,000 --> 00:35:53,359
Speaker 1: Jay has a lot of capability there too, but they

562
00:35:53,400 --> 00:35:56,120
Speaker 1: didn't have scale. So if we could help, that was

563
00:35:56,440 --> 00:35:59,840
Speaker 1: something that we could contribute. And I think that spirit

564
00:36:00,000 --> 00:36:05,640
Speaker 1: has permeated our entire ecosystem. Uh, you know, it's it's

565
00:36:05,640 --> 00:36:08,319
Speaker 1: easy to do that in the context of a crisis,

566
00:36:08,320 --> 00:36:10,919
Speaker 1: but some of that's going to last. And I think

567
00:36:11,000 --> 00:36:13,880
Speaker 1: the idea that we can actually be part of the

568
00:36:13,920 --> 00:36:18,440
Speaker 1: solution instead of perceived as the problem in our health system.

569
00:36:18,600 --> 00:36:20,919
Speaker 1: That's something that we can carry forward and I hope

570
00:36:21,040 --> 00:36:25,080
Speaker 1: build a reframing of not just our invitation, but of

571
00:36:25,120 --> 00:36:27,760
Speaker 1: the value that we can bring to people in their health.

572
00:36:28,880 --> 00:36:33,160
Speaker 1: It is a it is a mission of passion, but

573
00:36:33,280 --> 00:36:37,839
Speaker 1: it's also not over yet. One last question. I don't

574
00:36:37,880 --> 00:36:40,200
Speaker 1: want to end this on a on a sad note,

575
00:36:40,239 --> 00:36:43,040
Speaker 1: but there are a lot of people who are not

576
00:36:43,160 --> 00:36:47,520
Speaker 1: getting cancer screenings or did not get cancer screenings during

577
00:36:47,520 --> 00:36:52,400
Speaker 1: this period of time. Murk of course, Uh, manufacturers a

578
00:36:52,520 --> 00:36:57,280
Speaker 1: number of cancer fighting drugs as well. Um, how concerned

579
00:36:57,320 --> 00:37:04,160
Speaker 1: are you about people pausing they're critically important cancer screenings, um,

580
00:37:04,200 --> 00:37:08,680
Speaker 1: and which may result in tens of thousands of additional

581
00:37:08,719 --> 00:37:12,200
Speaker 1: cases of cancer. And what advice would you have for

582
00:37:12,280 --> 00:37:16,480
Speaker 1: people listening to this? You know, I saw a statistic

583
00:37:16,560 --> 00:37:21,560
Speaker 1: this morning that in between March and June and three

584
00:37:21,600 --> 00:37:26,200
Speaker 1: month period, four hundred and twenty thousand people miss their

585
00:37:26,440 --> 00:37:30,319
Speaker 1: expected cancer screenings. So just think about how that has

586
00:37:30,400 --> 00:37:34,000
Speaker 1: been multiplied over the course of this pandemic. And we

587
00:37:34,080 --> 00:37:37,440
Speaker 1: know in cancer that early diagnosis is the single most

588
00:37:37,480 --> 00:37:41,680
Speaker 1: important thing you can do to save lives and make

589
00:37:42,040 --> 00:37:46,160
Speaker 1: treatment much less complicated. So I predict that when we

590
00:37:46,200 --> 00:37:50,520
Speaker 1: start measuring the true impact of the pandemic, yes, we

591
00:37:50,560 --> 00:37:55,120
Speaker 1: will have the COVID related deaths, and maybe some unreported

592
00:37:55,160 --> 00:37:58,799
Speaker 1: COVID deaths are included in that number. But we're going

593
00:37:58,840 --> 00:38:04,719
Speaker 1: to see excess more stality from cancer diagnosed late um

594
00:38:04,800 --> 00:38:07,800
Speaker 1: and requiring much more complicated treatment. We're going to see

595
00:38:07,960 --> 00:38:11,800
Speaker 1: excess mortality down the road. We're already seeing as excess

596
00:38:11,840 --> 00:38:16,480
Speaker 1: mortality from cardiovascular disease and diabetes that's poorly controlled because

597
00:38:16,480 --> 00:38:20,160
Speaker 1: people aren't taking advantage of their health system during these

598
00:38:20,239 --> 00:38:25,760
Speaker 1: times of social distancing and fear. UM, we're missing immunizations UM.

599
00:38:25,960 --> 00:38:29,880
Speaker 1: The w h O recognizes that perhaps eighty million children

600
00:38:29,960 --> 00:38:33,880
Speaker 1: around the world have had impairment of their normal childhood

601
00:38:33,880 --> 00:38:37,840
Speaker 1: immunization programs. That's a tragedy waiting to happen. And I

602
00:38:38,120 --> 00:38:40,680
Speaker 1: always say I think measles is the canary in the

603
00:38:40,719 --> 00:38:43,279
Speaker 1: coal mine because you have to have such a high

604
00:38:43,360 --> 00:38:47,280
Speaker 1: level of coverage from measles. So when you see measles,

605
00:38:47,320 --> 00:38:51,520
Speaker 1: it means the immunization infrastructure has really broken down. And

606
00:38:51,560 --> 00:38:56,239
Speaker 1: we know that's the case. So the medical consequences of

607
00:38:56,320 --> 00:39:02,560
Speaker 1: COVID obviously are much greater than by itself, and I

608
00:39:02,640 --> 00:39:07,640
Speaker 1: just cannot encourage everybody UM strongly enough to be an

609
00:39:07,680 --> 00:39:12,880
Speaker 1: ambassador for returning to care, but particularly for cancer screening,

610
00:39:13,320 --> 00:39:17,440
Speaker 1: for management of chronic diseases, and for immunization for people

611
00:39:17,520 --> 00:39:22,200
Speaker 1: of all ages, and as an ambassador yourself. And I

612
00:39:22,239 --> 00:39:25,160
Speaker 1: will never forget the current effect because I was the

613
00:39:25,160 --> 00:39:30,840
Speaker 1: CDC director when you really destigmatize the importance of colonoscopy,

614
00:39:30,880 --> 00:39:34,000
Speaker 1: what that meant in terms of early diagnosis of so

615
00:39:34,120 --> 00:39:36,839
Speaker 1: many people who would have otherwise not known that they

616
00:39:36,880 --> 00:39:40,600
Speaker 1: had cancer and could participate in early treatment. So let's

617
00:39:40,640 --> 00:39:43,600
Speaker 1: all try to be ambassadors for returning to care and

618
00:39:43,640 --> 00:39:47,040
Speaker 1: get back on track, UM, for our well being and

619
00:39:47,040 --> 00:39:50,520
Speaker 1: our health maintenance. At the same time that we're being

620
00:39:50,520 --> 00:39:55,680
Speaker 1: careful and vigilant about this virus. Well, I'm all about that,

621
00:39:55,920 --> 00:39:58,960
Speaker 1: So UM, I think I want to urge everyone to

622
00:39:59,080 --> 00:40:03,640
Speaker 1: please contact their doctors and if they miss cancer screenings,

623
00:40:03,760 --> 00:40:07,560
Speaker 1: now is the time to schedule them, UM, and don't

624
00:40:07,600 --> 00:40:10,839
Speaker 1: put it off any longer. It's perfectly safe to go

625
00:40:10,960 --> 00:40:15,640
Speaker 1: there and so so critically important. Dr Julie Gerberdine, It's

626
00:40:15,640 --> 00:40:18,279
Speaker 1: always such a pleasure to talk to you. I think

627
00:40:18,320 --> 00:40:21,440
Speaker 1: you're a great communicator. Honestly, I think you are able

628
00:40:21,520 --> 00:40:24,800
Speaker 1: to take a lot of complicated medical issues and explain

629
00:40:24,880 --> 00:40:29,520
Speaker 1: them in a way that that's easily digestible and um,

630
00:40:29,560 --> 00:40:31,960
Speaker 1: that's not easy to do, but I feel like you

631
00:40:32,000 --> 00:40:34,920
Speaker 1: always do it. So thank you, so much, Thank you, Katie.

632
00:40:35,000 --> 00:40:41,279
Speaker 1: Coming from you, that means a lot. Thank you. This

633
00:40:41,360 --> 00:40:44,160
Speaker 1: episode of Next Question with Katie Kirk is brought to

634
00:40:44,200 --> 00:40:46,720
Speaker 1: you by Mark as part of its partnership with Katie

635
00:40:46,760 --> 00:40:52,920
Speaker 1: Kurk Media. Next Question with Katie Kirk is a production

636
00:40:52,960 --> 00:40:56,279
Speaker 1: of I Heart Media and Katie Kurk Media. The executive

637
00:40:56,280 --> 00:40:59,919
Speaker 1: producers are Me, Katie Kuric, and Courtney Litz. The sup

638
00:41:00,040 --> 00:41:05,600
Speaker 1: revising producers Lauren Hansen. Associate producers Derek Clements, Adriana Fasio,

639
00:41:05,920 --> 00:41:09,560
Speaker 1: and Emily Pinto. The show is edited and mixed by

640
00:41:09,640 --> 00:41:13,360
Speaker 1: Derrek Clements. For more information about today's episode, or to

641
00:41:13,400 --> 00:41:16,000
Speaker 1: sign up for my morning newsletter, wake Up Call, go

642
00:41:16,080 --> 00:41:18,719
Speaker 1: to Katie correct dot com. You can also find me

643
00:41:18,760 --> 00:41:22,840
Speaker 1: at Katie Currect on Instagram and all my social media channels.

644
00:41:22,880 --> 00:41:25,840
Speaker 1: For more podcasts from I Heart Radio, visit the I

645
00:41:25,960 --> 00:41:29,560
Speaker 1: Heart Radio app, Apple podcast or wherever you listen to

646
00:41:29,600 --> 00:41:30,640
Speaker 1: your favorite shows,