Speaker 1: Hi, everyone, I'm Katie Kuric, and this is next question.
Speaker 1: I recently had a conversation over zoom with CDC director
Speaker 1: Dr Rochelle Willinski. Now, I know everyone out there has
Speaker 1: COVID fatigue, duh, and you're probably really sick of even
Speaker 1: hearing about it. But the scary fact is almost people
Speaker 1: are still dying of COVID every day. So when is
Speaker 1: our long national, really international nightmare going to end? What
Speaker 1: is the state of play? Right now? That's how I
Speaker 1: began our conversation, right, So, first of all, I recognize
Speaker 1: everyone's tired. I recognize everybody wants to be out of this.
Speaker 1: I certainly want to be out of this, and and
Speaker 1: I'm with everyone. I'm in that if we sort of
Speaker 1: look at where we are today, UM cases are coming
Speaker 1: down from om Coon. They have been at record highs,
Speaker 1: but those cases are coming down, and they're coming down
Speaker 1: almost as swiftly as they went up. UM. Certainly, if
Speaker 1: we look at individual cities, we've seen them come down.
Speaker 1: As a lagging indicator, we have seen hospitalizations high, but
Speaker 1: those two are starting to come down. And then finally
Speaker 1: that our death rates UM are high, UM higher than
Speaker 1: we had seen in some other peaks UM, so around
Speaker 1: twenty three hundred a day. UM. So that is where
Speaker 1: we are right now. I certainly don't like to see
Speaker 1: our death counts as high as they are. Those continue
Speaker 1: to be tragic um with every single family they they touch.
Speaker 1: What I can't say though, is over time we have
Speaker 1: now are mounting more and more immunity in the population,
Speaker 1: the substrate of the population. As we get more and
Speaker 1: more people vaccinated, more and more people boosted, and people
Speaker 1: who are encountering disease who will get some background immunity
Speaker 1: from that. We have now background immunity, more background immunity
Speaker 1: in the population. And we also have a lot more
Speaker 1: tools than we used to. If you think, you know,
Speaker 1: you say year three in this pandemic, and that's where
Speaker 1: we are. But we also now have vaccines, we have
Speaker 1: a menu of therapeutics, we have more testing options, and
Speaker 1: so we're working now to you best utilize those tools
Speaker 1: in the context of what may lie ahead. You know,
Speaker 1: I get confused because we keep hearing that the omicron
Speaker 1: variant is less legal and yet, as you mentioned, twenty
Speaker 1: three hundred deaths a day, and that's the highest in
Speaker 1: nearly a year. So can you just explain how those
Speaker 1: two ideas can coexist. Yeah. I think that's a really
Speaker 1: important question. So milder does not mean mild, and I
Speaker 1: think mild can come in two different kinds of ways.
Speaker 1: For every single person that gets sick, if you were
Speaker 1: to get sick with O macron compared to delta, you
Speaker 1: might be less likely to end up in the hospital. However,
Speaker 1: or if we have three or four times the number
Speaker 1: of cases because of how transmissible OH macron is, we
Speaker 1: still end up with lots of people in the hospital
Speaker 1: and again lots of deaths. So it is this interplay
Speaker 1: between the absolute number of cases that you have and
Speaker 1: that each case for case may be less lethal, but
Speaker 1: because we have so many more, we still have challenges
Speaker 1: both in our hospitals and with our deaths. I know
Speaker 1: there have been breakthrough cases, but does the vaccine still
Speaker 1: seem to protect people from severe illness? And can you
Speaker 1: quantify the percentage of deaths from OH macron among the
Speaker 1: vaccinated population. Yeah. So here, here's what we know is
Speaker 1: that because of O macron two things have happened. One,
Speaker 1: you need more protection, more immune protection from O macron
Speaker 1: then you have with prior variants. And to just when
Speaker 1: O macron hit many people who have been previously vaccinated
Speaker 1: with their primary series, we're starting to wane in that protection,
Speaker 1: So people who are more than six months out of
Speaker 1: their primary series might have protection in the fifty pcent
Speaker 1: range in terms of severe disease presenting to an emergency department. However,
Speaker 1: with that booster shot, we can bolster that protection from
Speaker 1: that fifty to fifty five range all the way up
Speaker 1: to eight with that booster shot, which is why right
Speaker 1: now we're really encouraging people to get boosted. Here's what
Speaker 1: we know about what's in the hospital. The vast majority
Speaker 1: of people who are in the hospital continue to be
Speaker 1: people who are unvaccinated. We're also seeing people who are
Speaker 1: in the hospital who might have been vaccinated, but either
Speaker 1: they were vaccinated and not boosted, or they are people
Speaker 1: who might be less likely to have mounted a really
Speaker 1: good immune response to the vaccine, people who are older,
Speaker 1: people who are more immuno compromised. Latest data from the
Speaker 1: CDC on Friday demonstrated you are sixty eight times more
Speaker 1: likely to die from O. Macron um compared if you're
Speaker 1: unvaccinated compared to if you're boosted. Dr Lyndsky this may
Speaker 1: sound like a selfish question, but I think a lot
Speaker 1: of people maybe in my boat. I'm sixty five, I
Speaker 1: was boosted in November. Am I going to need a
Speaker 1: second booster or a fourth shot? Yeah? Right now, those
Speaker 1: data are really starting to emerge in terms of waning
Speaker 1: from your booster dose. UM. Certainly, we've seen in some
Speaker 1: countries Israel, for the most part, have been starting to
Speaker 1: think about and have been boosting their UM. They're older populations,
Speaker 1: they're more vulnerable populations. We haven't yet seen a lot
Speaker 1: of data on the waning protection from boosters in the
Speaker 1: context of Oh Macron, and those data are just forthcoming
Speaker 1: right now from the c d C. We are not
Speaker 1: recommending yet a boost an other booster dose. I know
Speaker 1: that you say milder doesn't necessarily mean mild yet. In
Speaker 1: an open letter to Governor Newsom for UCSF, doctors including
Speaker 1: the Director of COVID Response, are calling on state leaders
Speaker 1: to acknowledge the transition of COVID to an endemic disease
Speaker 1: and lift most masking policies for school aged children. What's
Speaker 1: your response to that? Yeah, Um, well, I'll go back
Speaker 1: to we all want to be in a place where
Speaker 1: we are not living in a crisis situation. In my mind,
Speaker 1: one of the places we have to look out first
Speaker 1: is how are our hospitals doing. Um. Can our hospitals
Speaker 1: take care of not just the COVID patients that are
Speaker 1: in there, but can they manage the routine medical care
Speaker 1: that should that comes in every single day? Our motor
Speaker 1: vehicle accidents, are our heart attacks, are strokes? And how
Speaker 1: are they doing? Because that is one of the indicators,
Speaker 1: a barometer, if you will, that I look at to
Speaker 1: a can we start um getting back out of this
Speaker 1: crisis mode? And I would say all of us are
Speaker 1: looking forward to that and want to sort of get
Speaker 1: to that place, But in so many parts of the
Speaker 1: country we are not there yet. We are still seeing
Speaker 1: hospital capacities that are overwhelmed and not able to do so.
Speaker 1: And so that is a place that we all want
Speaker 1: to be and that we're all aiming for, preparing for,
Speaker 1: and yet we're not there quite yet. Let's shoun there
Speaker 1: be certain regulations or recommendations or restrictions depending on the
Speaker 1: region you're living in and the circumstances that are happening
Speaker 1: in that area. Absolutely, and in fact, we do at
Speaker 1: CDC have a map stratified by county. Actually, that looks
Speaker 1: at how every individual county is doing in terms of
Speaker 1: cases per hundred thousand. We look at both hospitalizations as
Speaker 1: well as death counts, and right now those cases are
Speaker 1: still across the country um over every county, nearly every
Speaker 1: county in the country is read. It is those cases
Speaker 1: that actually help us inform when people can and should
Speaker 1: be able to take off their masks um And so
Speaker 1: we do do that at the jurisdictional level because as
Speaker 1: you know very much, many of these is we're a
Speaker 1: very big country. We're uneven with regard to how our
Speaker 1: cases are, how our vaccination rates are, how our hospitals
Speaker 1: are doing. But right now I will remind people, you know,
Speaker 1: O Macron hit us with a lot of cases, and
Speaker 1: so right now we're not quite ready to do that
Speaker 1: more with Dr Rochelle Willinsky in just a moment, I'm
Speaker 1: almost afraid to ask this, but an Overcrons sub variant
Speaker 1: b A two has already been found in nearly fifty countries.
Speaker 1: So what do we know about this variant? How concerned
Speaker 1: should we be? Right? Really important questions? So be a
Speaker 1: too is what they call a sub lineage A sister
Speaker 1: of m B A one, which is the most prominent
Speaker 1: UM O macron sublineage we have, so most of what
Speaker 1: we have here in the United States, over ninety point
Speaker 1: five percent of all macron is O macron, and the
Speaker 1: large majority of that, the vast majority of that is
Speaker 1: the B A one sublineage. UM. Now we started to
Speaker 1: dedect this be a too sublineage. We have seen it
Speaker 1: in some areas UM in Denmark and in UM in
Speaker 1: the UK, well Denmark and India, where it's become more dominant.
Speaker 1: In the UK it's still less than one percent. We're
Speaker 1: starting to learn more and more about it. We haven't
Speaker 1: yet seen any more severe disease from it, and it
Speaker 1: does look like our current vaccines will work about as
Speaker 1: well as they did as they do against the O
Speaker 1: macron itself. It might be a little bit more transmissible,
Speaker 1: which may be the reason we're seeing more and more
Speaker 1: of it in certain countries. Here in the United States.
Speaker 1: We've detected it, we've actually known about it here in
Speaker 1: the United States since mid December. We haven't yet seen
Speaker 1: it ratchet up in terms of seeing more and more
Speaker 1: of it. We have a handful of cases here and
Speaker 1: we're continuing to follow it very carefully. So this one
Speaker 1: doesn't seem to be of grave concerned. I mean, how
Speaker 1: worried are you, Dr Wilynsky? Every day you're going to
Speaker 1: hear about a much more serious variant. I don't need
Speaker 1: to be a DEBBI downer, but are we going to
Speaker 1: have to be on a constant state of alert that
Speaker 1: that an even deadlier variant maybe right around the corner.
Speaker 1: So that is our job is to be on a
Speaker 1: constant state of alert. That's our job at CDC. But
Speaker 1: really I think the important thing is to be alert
Speaker 1: and prepared and not yet necessarily to panic, right because
Speaker 1: we know that our vaccines right now it looks like
Speaker 1: are working against oh Macron, not quite as well as
Speaker 1: they did against um against Delta, but they are working well,
Speaker 1: especially if you get boosted. And our job is to
Speaker 1: follow these variants. We do know as long as we
Speaker 1: have circulating virus, we have the potential for variants. But
Speaker 1: what the long term goal is is to be able
Speaker 1: to manage these variants and to not have a crisis
Speaker 1: every time we have a variant, but to be able
Speaker 1: to live in the context of the potential variants that
Speaker 1: might emerge, and that means that our testing is working,
Speaker 1: our therapeutics are working, and our vaccines are continually working
Speaker 1: and up to date. So will this be the new
Speaker 1: normal something we just live with and manage with annual
Speaker 1: shots that hopefully can combat whatever strain comes along. Um.
Speaker 1: I don't want to pretend that I'm content with where
Speaker 1: we are right now as being a new normal. We
Speaker 1: are coming down from a pretty robust surge, and so
Speaker 1: that I don't think is a new normal place. I
Speaker 1: envision a new normal place UM where our hospitals can manage,
Speaker 1: where our workforce is back, UM, where we might have
Speaker 1: to combat many surges, um, but that we have the tools,
Speaker 1: the tests, that therapeutics, the vaccines that work. Jury is
Speaker 1: still out as to whether and how often we will
Speaker 1: need to have those vaccines. It may be that we
Speaker 1: need them annually. It maybe just like you roll up
Speaker 1: your sleep for your flu shot every year, you roll
Speaker 1: up your sleep for your COVID shot every year. And
Speaker 1: we still have more science to learn from in order
Speaker 1: to see if that's where we're going to be. Even
Speaker 1: if it's endemic, it could still be quite dangerous. Yeah. UM,
Speaker 1: what I would say is I would like to be
Speaker 1: in a place where we are endemic at relatively low
Speaker 1: rates of disease, where we have low rates of disease,
Speaker 1: high rates of vaccination, high rates of protection, and certainly
Speaker 1: low level of death. I also want to remind people
Speaker 1: that even with a vaccination, even for those um, even
Speaker 1: with vaccination, we have the capacity. Now we have new
Speaker 1: therapeutics and and even more science that continues to evolve,
Speaker 1: and some of those therapeutics can also, as I say,
Speaker 1: take the fangs out of this and really lead to
Speaker 1: less severe disease. So we have a lot of tools
Speaker 1: in the toolbox and working now to scale those up
Speaker 1: to make sure that everyone has access to them. Children
Speaker 1: under five still aren't able to get the vaccine, as
Speaker 1: you know, and I get this question constantly on social media.
Speaker 1: When will we see that approved? And does that give
Speaker 1: you pause? It all the idea of vaccinating children under five.
Speaker 1: You know the companies are working towards the timeline for
Speaker 1: children under five. I can't tell you exactly when that
Speaker 1: will be with a date certain, and I know parents
Speaker 1: are really anxious. Um when it happens through the f
Speaker 1: d A process through to the c d C process,
Speaker 1: I can tell you, Um, it won't happen with me
Speaker 1: at the helmet CDC unless all of that due diligence
Speaker 1: is done such that I would be comfortable allvaccinating any
Speaker 1: child that I would have that's under the age of five,
Speaker 1: so that I can that I can say. What I
Speaker 1: can say is we really need to work to vaccinate
Speaker 1: all those who are around our children under five, because
Speaker 1: we have seen time and time again that in households
Speaker 1: where you have two and three people vaccinated, you surround them,
Speaker 1: you you cocoon children under five um that they are
Speaker 1: less likely to get disease. And right now, you know,
Speaker 1: we have about fifty two per cent of our teenagers
Speaker 1: who have received their primary series, about twenty percent of
Speaker 1: our children between the ages of five to eleven. So
Speaker 1: we have a lot of work to do, and I
Speaker 1: would encourage parents to get their children who are eligible
Speaker 1: vaccinated so that we can really protect those who aren't
Speaker 1: eligible yet. A lot of people on social media also
Speaker 1: wanted me to ask you about the troubling cases of
Speaker 1: long COVID. Is the CDC collecting data on this. Many
Speaker 1: of those folks feel that they've been sort of abandoned
Speaker 1: by the medical establishment. Yeah, so we have a lot
Speaker 1: of studies that are ongoing at CDC, both a surveillance
Speaker 1: level as well as UM through electronic health records, and
Speaker 1: i AGE actually has quite a bit of funding to
Speaker 1: look at the manifestations and disease of long COVID and
Speaker 1: to try and understand how we intervene with long COVID.
Speaker 1: So there are many resources. The one thing I do
Speaker 1: want to say here, and I think it's really important,
Speaker 1: is that UM, you know, COVID hit UM disproportionately across
Speaker 1: the United States, and we've seen that. We've seen that
Speaker 1: in more vulnerable populations, We've seen that in racial and
Speaker 1: ethnic minority communities and UM. Because of that, that will
Speaker 1: have implications on who gets long COVID, and so I
Speaker 1: think we have a responsibility to make sure that those
Speaker 1: patients who were hardest hit by the original wave of
Speaker 1: waves of COVID nineteen that we worked to provide them resources,
Speaker 1: access to medical care. UM for those who have received
Speaker 1: long who have long covid UM. We don't have a
Speaker 1: lot of data yet on O macron and long covid
Speaker 1: UM because we certainly just certainly hasn't been with us enough.
Speaker 1: But we're talking to our international community. Those who have
Speaker 1: had COVID before US, South Africa, UK O, Macron before
Speaker 1: US South Africa and UK so that we can have
Speaker 1: sort of an earlier window as to what's happening there,
Speaker 1: and then we of course will continue those studies here.
Speaker 1: We'll be right back. I know this is a politically
Speaker 1: charged question, but it's still unclear how this virus started.
Speaker 1: No animal host has been found, and there are many
Speaker 1: critics who believe that this could have come from a
Speaker 1: lab in luhan On and it's somehow being covered up.
Speaker 1: What's your response to that, UM, you, I think it's
Speaker 1: an important question. Um. We may not be able to
Speaker 1: get to the bottom of that question. What I can
Speaker 1: say is that we have known many prior coronavirus, and
Speaker 1: I don't have insight into the truth behind that question.
Speaker 1: I think it it would be helpful historically and scientifically
Speaker 1: to know and understand it. I think we should do
Speaker 1: everything we can scientifically to understand it. I also know
Speaker 1: that historically coronavirus is whether they be stars or mirs,
Speaker 1: have traditionally come from an animal zooonotic source. So we
Speaker 1: have history that suggested the capacity to jump UM, but
Speaker 1: that is not just definitive for this virus, so you
Speaker 1: wouldn't rule out the possibility. I haven't had enough window
Speaker 1: into the science to to be able to say, and
Speaker 1: I don't know that we will ever be able to
Speaker 1: discern it. Tragically, it's been baptism by fire for you.
Speaker 1: Welcome to the world of being a public figure, Dr Willinsky.
Speaker 1: And there's been a lot of criticism of the CDC's
Speaker 1: public messaging. Looking back, what would you have done differently
Speaker 1: or what do you think the missteps might have been? Yeah,
Speaker 1: I think a lot about this. Um. First, let me say, UM,
Speaker 1: I came out and said I was going to lead
Speaker 1: with the science, and that is what I have done,
Speaker 1: and it has been my north star. I came from
Speaker 1: the bedside UM when I joined the CDC, and it
Speaker 1: is you know, the patients, every single one of them
Speaker 1: as individuals and collectively in public health, that drive how
Speaker 1: I make decisions. Um, that science during a pandemic is
Speaker 1: fast moving, and sometimes that science is gray, and you
Speaker 1: have to make decisions when you don't have all the
Speaker 1: perfect science that you would like because the situation at
Speaker 1: self is imperfect. I think given the curveballs that we've
Speaker 1: seen through this pandemic, much of what I might have
Speaker 1: done differently, is to say for now or UM, this
Speaker 1: could change or you know there there's much that we
Speaker 1: are continuing to learn because we have had to update
Speaker 1: our science as we've learned, as in our guidance, as
Speaker 1: we've learned new science, UM, and so much of that
Speaker 1: would have been Actually we need to continue to be
Speaker 1: humble as we learn more and more. A lot of
Speaker 1: people watching this, are listening to this are thinking, Okay,
Speaker 1: I mean, you hear about COVID fatigue everywhere. Dr Wilenski,
Speaker 1: I know you don't have a crystal ball, but when
Speaker 1: you look at the data that you currently have, when
Speaker 1: you hear Dr Falk say this will peak in mid February,
Speaker 1: when realistically do you think we might be able to
Speaker 1: get back to normal? UM. So let me tell you
Speaker 1: what I think normal looks like, and that is we
Speaker 1: talked a little bit about those our hospitals can manage
Speaker 1: patients coming in. UM. We are in a place where
Speaker 1: we can start enjoying UH activities that we once knew
Speaker 1: and loved. UM. I know everybody is interested in taking
Speaker 1: off their masks, and what I would say is we
Speaker 1: should manage the expectations that on you know, any given
Speaker 1: date certain that will be back to normal, because I
Speaker 1: think we're gonna tiptoe towards normal UM, and we'll increasingly
Speaker 1: over time, UM, providing that there is not another variant
Speaker 1: that throws us a curveball, increasingly over time be able
Speaker 1: to UM start peeling back all of those layers of
Speaker 1: protection that we have had UM. But I don't think
Speaker 1: that I think we should manage the expectation that on
Speaker 1: any given date we will be there. Finally, we ask
Speaker 1: you one other question, because you've been super generous with
Speaker 1: your time, but I think this is really important. I
Speaker 1: know that you believe this public health crisis has really
Speaker 1: shown a spotlight on the deficiencies and our public health
Speaker 1: system and how we need to bolster it. What do
Speaker 1: you think needs to be done so we're better prepared
Speaker 1: for the next I don't want to say this, but
Speaker 1: the next public health crisis, whatever that might be. Thank
Speaker 1: you for asking that question, because we have so much
Speaker 1: work to do. So over the last decade UM, we
Speaker 1: have had H one, N one, Ebola, ZEKA, and now COVID,
Speaker 1: and over that last decade there's an anticipation that we're
Speaker 1: now eighty thousand people in deficit in our public health workforce.
Speaker 1: So not only do we need the sheer volume in
Speaker 1: the number of people, but we need to scale up
Speaker 1: our workforce, upskill our workforce so that we have in
Speaker 1: any given community community health workers and genomic epithem neologists.
Speaker 1: So we have a lot of work to do in
Speaker 1: scaling up this gil UM and and share volume of people.
Speaker 1: Public health has to be an attractive place to enter.
Speaker 1: It's an incredible career UM, It's it's very other oriented
Speaker 1: and it's just incredible what you can do in public health.
Speaker 1: Our data systems have been frail, they have been untended
Speaker 1: to UM. We need to be able to have the
Speaker 1: pipes connect so that data from one state can easily
Speaker 1: communicate with data from another, that all can come together
Speaker 1: at c DC so we can compare different trends so
Speaker 1: that as you say, our region that's running into a challenge,
Speaker 1: we would be able to see UM quickly. And then
Speaker 1: we need to scale up our lab capacity or laboratory
Speaker 1: capacity at every different at every different jurisdiction and state,
Speaker 1: so that we have immediate capacity to detect challenges locally
Speaker 1: where they are. We have a lot of work to
Speaker 1: do in our public health workforce and in our public
Speaker 1: health infrastructure. And that's what I'm really trying and working
Speaker 1: and committed to be able to do um as we're
Speaker 1: sort of shining a light on where our deficiencies were
Speaker 1: coming in. It must be heartening for you to hear
Speaker 1: that applications to medical schools have skyrocketed as a result
Speaker 1: of this pandemic or increased dramatically. I don't know if
Speaker 1: skyrocketing is hyperbolic, but it must be heartening to you
Speaker 1: that many more people are at least applying to medical school,
Speaker 1: which is good. Is but some of those people need
Speaker 1: to go into public health when they graduate well, and
Speaker 1: I was one of them, so um so I do.
Speaker 1: There is an incredible pathway through medicine to public health.
Speaker 1: There's an incredible pathway through schools of public health, and
Speaker 1: really so many different pathways. And yes, it's really encouraging.
Speaker 1: I love talking to young people who want to who
Speaker 1: wanna have taken this moment really of this pandemic and said, actually,
Speaker 1: this is what I want to do now. They were
Speaker 1: moved by this moment. I was moved in my career
Speaker 1: by the moment of the HIV epidemic that was that
Speaker 1: was motivating so many of us to enter medicine at
Speaker 1: the time, and so um take this moment um and
Speaker 1: and uh work towards taking that incredible talent of these
Speaker 1: applicants and moving on towards public out. Dr Rochelle Wilensky.
Speaker 1: Dr Wilenski, it's really great to talk to you. Thank
Speaker 1: you so much for doing this this interview. We really
Speaker 1: appreciate it. Thank you so much for having me. Next
Speaker 1: Question with Katie Kurik is a production of I Heart
Speaker 1: Media and Katie Kurk Media. The executive producers Army, Katie Curic,
Speaker 1: and Courtney Litz. The supervising producer is Lauren Hansen. Associate
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