WEBVTT - Bonus: Tip-toeing toward a new normal with CDC Director Dr. Rochelle Walensky 0:00:00.360 --> 0:00:03.279 Hi, everyone, I'm Katie Kuric, and this is next question. 0:00:04.559 --> 0:00:08.520 I recently had a conversation over zoom with CDC director 0:00:08.640 --> 0:00:13.000 Dr Rochelle Willinski. Now, I know everyone out there has 0:00:13.080 --> 0:00:17.239 COVID fatigue, duh, and you're probably really sick of even 0:00:17.280 --> 0:00:22.920 hearing about it. But the scary fact is almost people 0:00:23.280 --> 0:00:28.000 are still dying of COVID every day. So when is 0:00:28.000 --> 0:00:32.640 our long national, really international nightmare going to end? What 0:00:32.840 --> 0:00:36.320 is the state of play? Right now? That's how I 0:00:36.400 --> 0:00:41.840 began our conversation, right, So, first of all, I recognize 0:00:41.880 --> 0:00:44.760 everyone's tired. I recognize everybody wants to be out of this. 0:00:44.920 --> 0:00:46.760 I certainly want to be out of this, and and 0:00:47.040 --> 0:00:50.000 I'm with everyone. I'm in that if we sort of 0:00:50.040 --> 0:00:53.960 look at where we are today, UM cases are coming 0:00:53.960 --> 0:00:56.760 down from om Coon. They have been at record highs, 0:00:56.800 --> 0:00:58.920 but those cases are coming down, and they're coming down 0:00:58.960 --> 0:01:01.800 almost as swiftly as they went up. UM. Certainly, if 0:01:01.800 --> 0:01:04.360 we look at individual cities, we've seen them come down. 0:01:05.000 --> 0:01:08.640 As a lagging indicator, we have seen hospitalizations high, but 0:01:08.720 --> 0:01:12.240 those two are starting to come down. And then finally 0:01:12.280 --> 0:01:15.640 that our death rates UM are high, UM higher than 0:01:15.680 --> 0:01:19.360 we had seen in some other peaks UM, so around 0:01:19.360 --> 0:01:22.520 twenty three hundred a day. UM. So that is where 0:01:22.520 --> 0:01:25.560 we are right now. I certainly don't like to see 0:01:26.040 --> 0:01:28.720 our death counts as high as they are. Those continue 0:01:28.840 --> 0:01:33.880 to be tragic um with every single family they they touch. 0:01:34.920 --> 0:01:39.000 What I can't say though, is over time we have 0:01:39.160 --> 0:01:43.280 now are mounting more and more immunity in the population, 0:01:43.319 --> 0:01:45.679 the substrate of the population. As we get more and 0:01:45.760 --> 0:01:49.480 more people vaccinated, more and more people boosted, and people 0:01:49.480 --> 0:01:52.920 who are encountering disease who will get some background immunity 0:01:53.000 --> 0:01:57.240 from that. We have now background immunity, more background immunity 0:01:57.280 --> 0:02:00.120 in the population. And we also have a lot more 0:02:00.120 --> 0:02:02.320 tools than we used to. If you think, you know, 0:02:02.520 --> 0:02:04.840 you say year three in this pandemic, and that's where 0:02:04.840 --> 0:02:08.800 we are. But we also now have vaccines, we have 0:02:09.080 --> 0:02:13.760 a menu of therapeutics, we have more testing options, and 0:02:13.840 --> 0:02:17.600 so we're working now to you best utilize those tools 0:02:17.639 --> 0:02:21.720 in the context of what may lie ahead. You know, 0:02:21.880 --> 0:02:25.560 I get confused because we keep hearing that the omicron 0:02:25.800 --> 0:02:31.040 variant is less legal and yet, as you mentioned, twenty 0:02:31.120 --> 0:02:35.040 three hundred deaths a day, and that's the highest in 0:02:35.160 --> 0:02:38.680 nearly a year. So can you just explain how those 0:02:38.720 --> 0:02:43.119 two ideas can coexist. Yeah. I think that's a really 0:02:43.200 --> 0:02:47.480 important question. So milder does not mean mild, and I 0:02:47.520 --> 0:02:50.280 think mild can come in two different kinds of ways. 0:02:50.639 --> 0:02:53.680 For every single person that gets sick, if you were 0:02:53.720 --> 0:02:56.240 to get sick with O macron compared to delta, you 0:02:56.320 --> 0:02:59.920 might be less likely to end up in the hospital. However, 0:03:00.080 --> 0:03:02.320 or if we have three or four times the number 0:03:02.360 --> 0:03:06.960 of cases because of how transmissible OH macron is, we 0:03:07.080 --> 0:03:09.919 still end up with lots of people in the hospital 0:03:10.000 --> 0:03:13.680 and again lots of deaths. So it is this interplay 0:03:13.760 --> 0:03:17.040 between the absolute number of cases that you have and 0:03:17.120 --> 0:03:20.560 that each case for case may be less lethal, but 0:03:20.680 --> 0:03:23.840 because we have so many more, we still have challenges 0:03:23.880 --> 0:03:27.120 both in our hospitals and with our deaths. I know 0:03:27.240 --> 0:03:31.519 there have been breakthrough cases, but does the vaccine still 0:03:31.560 --> 0:03:35.960 seem to protect people from severe illness? And can you 0:03:36.560 --> 0:03:41.120 quantify the percentage of deaths from OH macron among the 0:03:41.200 --> 0:03:47.600 vaccinated population. Yeah. So here, here's what we know is 0:03:47.680 --> 0:03:50.720 that because of O macron two things have happened. One, 0:03:51.200 --> 0:03:54.560 you need more protection, more immune protection from O macron 0:03:54.640 --> 0:03:58.119 then you have with prior variants. And to just when 0:03:58.120 --> 0:04:01.760 O macron hit many people who have been previously vaccinated 0:04:01.800 --> 0:04:05.600 with their primary series, we're starting to wane in that protection, 0:04:06.120 --> 0:04:08.600 So people who are more than six months out of 0:04:08.640 --> 0:04:13.280 their primary series might have protection in the fifty pcent 0:04:13.600 --> 0:04:18.120 range in terms of severe disease presenting to an emergency department. However, 0:04:18.240 --> 0:04:22.000 with that booster shot, we can bolster that protection from 0:04:22.040 --> 0:04:24.280 that fifty to fifty five range all the way up 0:04:24.320 --> 0:04:28.520 to eight with that booster shot, which is why right 0:04:28.520 --> 0:04:32.680 now we're really encouraging people to get boosted. Here's what 0:04:32.800 --> 0:04:35.400 we know about what's in the hospital. The vast majority 0:04:35.440 --> 0:04:38.919 of people who are in the hospital continue to be 0:04:39.120 --> 0:04:42.880 people who are unvaccinated. We're also seeing people who are 0:04:42.920 --> 0:04:46.039 in the hospital who might have been vaccinated, but either 0:04:46.120 --> 0:04:50.279 they were vaccinated and not boosted, or they are people 0:04:50.360 --> 0:04:53.599 who might be less likely to have mounted a really 0:04:53.640 --> 0:04:57.120 good immune response to the vaccine, people who are older, 0:04:57.279 --> 0:05:01.000 people who are more immuno compromised. Latest data from the 0:05:01.040 --> 0:05:06.360 CDC on Friday demonstrated you are sixty eight times more 0:05:06.400 --> 0:05:11.240 likely to die from O. Macron um compared if you're 0:05:11.680 --> 0:05:16.240 unvaccinated compared to if you're boosted. Dr Lyndsky this may 0:05:16.279 --> 0:05:18.440 sound like a selfish question, but I think a lot 0:05:18.440 --> 0:05:21.960 of people maybe in my boat. I'm sixty five, I 0:05:22.080 --> 0:05:25.480 was boosted in November. Am I going to need a 0:05:25.520 --> 0:05:29.680 second booster or a fourth shot? Yeah? Right now, those 0:05:29.760 --> 0:05:32.760 data are really starting to emerge in terms of waning 0:05:32.920 --> 0:05:37.080 from your booster dose. UM. Certainly, we've seen in some 0:05:37.120 --> 0:05:40.120 countries Israel, for the most part, have been starting to 0:05:40.120 --> 0:05:44.480 think about and have been boosting their UM. They're older populations, 0:05:44.480 --> 0:05:47.880 they're more vulnerable populations. We haven't yet seen a lot 0:05:47.920 --> 0:05:52.280 of data on the waning protection from boosters in the 0:05:52.400 --> 0:05:55.760 context of Oh Macron, and those data are just forthcoming 0:05:56.120 --> 0:05:58.080 right now from the c d C. We are not 0:05:58.200 --> 0:06:03.160 recommending yet a boost an other booster dose. I know 0:06:03.279 --> 0:06:08.599 that you say milder doesn't necessarily mean mild yet. In 0:06:08.680 --> 0:06:13.760 an open letter to Governor Newsom for UCSF, doctors including 0:06:13.800 --> 0:06:17.479 the Director of COVID Response, are calling on state leaders 0:06:17.560 --> 0:06:21.480 to acknowledge the transition of COVID to an endemic disease 0:06:21.520 --> 0:06:25.880 and lift most masking policies for school aged children. What's 0:06:25.880 --> 0:06:29.880 your response to that? Yeah, Um, well, I'll go back 0:06:29.920 --> 0:06:32.679 to we all want to be in a place where 0:06:32.720 --> 0:06:36.719 we are not living in a crisis situation. In my mind, 0:06:36.839 --> 0:06:39.080 one of the places we have to look out first 0:06:39.279 --> 0:06:42.960 is how are our hospitals doing. Um. Can our hospitals 0:06:43.040 --> 0:06:45.360 take care of not just the COVID patients that are 0:06:45.360 --> 0:06:48.120 in there, but can they manage the routine medical care 0:06:48.200 --> 0:06:50.640 that should that comes in every single day? Our motor 0:06:50.720 --> 0:06:54.760 vehicle accidents, are our heart attacks, are strokes? And how 0:06:54.800 --> 0:06:57.680 are they doing? Because that is one of the indicators, 0:06:57.680 --> 0:06:59.720 a barometer, if you will, that I look at to 0:07:00.000 --> 0:07:04.120 a can we start um getting back out of this 0:07:04.279 --> 0:07:06.640 crisis mode? And I would say all of us are 0:07:06.680 --> 0:07:09.840 looking forward to that and want to sort of get 0:07:09.880 --> 0:07:12.040 to that place, But in so many parts of the 0:07:12.080 --> 0:07:14.600 country we are not there yet. We are still seeing 0:07:14.680 --> 0:07:18.600 hospital capacities that are overwhelmed and not able to do so. 0:07:18.920 --> 0:07:20.720 And so that is a place that we all want 0:07:20.720 --> 0:07:23.880 to be and that we're all aiming for, preparing for, 0:07:24.280 --> 0:07:27.360 and yet we're not there quite yet. Let's shoun there 0:07:27.480 --> 0:07:33.200 be certain regulations or recommendations or restrictions depending on the 0:07:33.240 --> 0:07:36.640 region you're living in and the circumstances that are happening 0:07:36.720 --> 0:07:40.720 in that area. Absolutely, and in fact, we do at 0:07:40.760 --> 0:07:45.480 CDC have a map stratified by county. Actually, that looks 0:07:45.520 --> 0:07:49.120 at how every individual county is doing in terms of 0:07:49.160 --> 0:07:53.520 cases per hundred thousand. We look at both hospitalizations as 0:07:53.560 --> 0:07:56.760 well as death counts, and right now those cases are 0:07:56.800 --> 0:08:01.400 still across the country um over every county, nearly every 0:08:01.400 --> 0:08:04.160 county in the country is read. It is those cases 0:08:04.200 --> 0:08:07.800 that actually help us inform when people can and should 0:08:07.800 --> 0:08:10.480 be able to take off their masks um And so 0:08:10.560 --> 0:08:13.680 we do do that at the jurisdictional level because as 0:08:13.760 --> 0:08:16.520 you know very much, many of these is we're a 0:08:16.640 --> 0:08:20.040 very big country. We're uneven with regard to how our 0:08:20.080 --> 0:08:23.720 cases are, how our vaccination rates are, how our hospitals 0:08:23.720 --> 0:08:26.560 are doing. But right now I will remind people, you know, 0:08:26.720 --> 0:08:30.000 O Macron hit us with a lot of cases, and 0:08:30.040 --> 0:08:31.960 so right now we're not quite ready to do that 0:08:33.559 --> 0:08:46.079 more with Dr Rochelle Willinsky in just a moment, I'm 0:08:46.080 --> 0:08:49.280 almost afraid to ask this, but an Overcrons sub variant 0:08:49.679 --> 0:08:53.040 b A two has already been found in nearly fifty countries. 0:08:53.440 --> 0:08:55.920 So what do we know about this variant? How concerned 0:08:55.960 --> 0:08:59.640 should we be? Right? Really important questions? So be a 0:09:00.000 --> 0:09:03.080 too is what they call a sub lineage A sister 0:09:03.480 --> 0:09:06.080 of m B A one, which is the most prominent 0:09:06.320 --> 0:09:09.840 UM O macron sublineage we have, so most of what 0:09:09.920 --> 0:09:12.880 we have here in the United States, over ninety point 0:09:12.960 --> 0:09:15.720 five percent of all macron is O macron, and the 0:09:15.800 --> 0:09:18.800 large majority of that, the vast majority of that is 0:09:18.840 --> 0:09:22.560 the B A one sublineage. UM. Now we started to 0:09:22.600 --> 0:09:26.080 dedect this be a too sublineage. We have seen it 0:09:26.160 --> 0:09:30.400 in some areas UM in Denmark and in UM in 0:09:30.440 --> 0:09:35.280 the UK, well Denmark and India, where it's become more dominant. 0:09:35.600 --> 0:09:38.480 In the UK it's still less than one percent. We're 0:09:38.520 --> 0:09:41.000 starting to learn more and more about it. We haven't 0:09:41.080 --> 0:09:44.280 yet seen any more severe disease from it, and it 0:09:44.320 --> 0:09:47.280 does look like our current vaccines will work about as 0:09:47.280 --> 0:09:50.240 well as they did as they do against the O 0:09:50.360 --> 0:09:55.040 macron itself. It might be a little bit more transmissible, 0:09:55.160 --> 0:09:57.760 which may be the reason we're seeing more and more 0:09:57.800 --> 0:10:00.680 of it in certain countries. Here in the United States. 0:10:00.760 --> 0:10:03.360 We've detected it, we've actually known about it here in 0:10:03.360 --> 0:10:07.760 the United States since mid December. We haven't yet seen 0:10:08.240 --> 0:10:11.040 it ratchet up in terms of seeing more and more 0:10:11.080 --> 0:10:13.480 of it. We have a handful of cases here and 0:10:13.480 --> 0:10:16.959 we're continuing to follow it very carefully. So this one 0:10:17.040 --> 0:10:21.040 doesn't seem to be of grave concerned. I mean, how 0:10:21.160 --> 0:10:23.760 worried are you, Dr Wilynsky? Every day you're going to 0:10:23.880 --> 0:10:27.120 hear about a much more serious variant. I don't need 0:10:27.120 --> 0:10:29.320 to be a DEBBI downer, but are we going to 0:10:29.400 --> 0:10:32.160 have to be on a constant state of alert that 0:10:32.160 --> 0:10:35.920 that an even deadlier variant maybe right around the corner. 0:10:37.240 --> 0:10:39.400 So that is our job is to be on a 0:10:39.480 --> 0:10:42.520 constant state of alert. That's our job at CDC. But 0:10:42.760 --> 0:10:45.800 really I think the important thing is to be alert 0:10:45.920 --> 0:10:50.000 and prepared and not yet necessarily to panic, right because 0:10:50.320 --> 0:10:52.920 we know that our vaccines right now it looks like 0:10:52.960 --> 0:10:55.839 are working against oh Macron, not quite as well as 0:10:55.840 --> 0:10:59.520 they did against um against Delta, but they are working well, 0:10:59.679 --> 0:11:02.280 especially if you get boosted. And our job is to 0:11:02.320 --> 0:11:04.520 follow these variants. We do know as long as we 0:11:04.559 --> 0:11:08.280 have circulating virus, we have the potential for variants. But 0:11:08.400 --> 0:11:11.000 what the long term goal is is to be able 0:11:11.040 --> 0:11:14.080 to manage these variants and to not have a crisis 0:11:14.120 --> 0:11:16.600 every time we have a variant, but to be able 0:11:16.640 --> 0:11:19.520 to live in the context of the potential variants that 0:11:19.600 --> 0:11:22.680 might emerge, and that means that our testing is working, 0:11:22.720 --> 0:11:26.320 our therapeutics are working, and our vaccines are continually working 0:11:26.320 --> 0:11:28.960 and up to date. So will this be the new 0:11:29.000 --> 0:11:33.360 normal something we just live with and manage with annual 0:11:33.400 --> 0:11:38.840 shots that hopefully can combat whatever strain comes along. Um. 0:11:38.880 --> 0:11:42.240 I don't want to pretend that I'm content with where 0:11:42.280 --> 0:11:44.800 we are right now as being a new normal. We 0:11:44.840 --> 0:11:48.720 are coming down from a pretty robust surge, and so 0:11:48.800 --> 0:11:51.240 that I don't think is a new normal place. I 0:11:51.360 --> 0:11:56.760 envision a new normal place UM where our hospitals can manage, 0:11:56.920 --> 0:12:00.920 where our workforce is back, UM, where we might have 0:12:01.040 --> 0:12:05.600 to combat many surges, um, but that we have the tools, 0:12:05.679 --> 0:12:10.000 the tests, that therapeutics, the vaccines that work. Jury is 0:12:10.040 --> 0:12:12.880 still out as to whether and how often we will 0:12:12.920 --> 0:12:15.560 need to have those vaccines. It may be that we 0:12:15.600 --> 0:12:18.240 need them annually. It maybe just like you roll up 0:12:18.280 --> 0:12:20.520 your sleep for your flu shot every year, you roll 0:12:20.600 --> 0:12:22.920 up your sleep for your COVID shot every year. And 0:12:22.960 --> 0:12:25.360 we still have more science to learn from in order 0:12:25.400 --> 0:12:27.720 to see if that's where we're going to be. Even 0:12:27.760 --> 0:12:33.400 if it's endemic, it could still be quite dangerous. Yeah. UM, 0:12:33.440 --> 0:12:35.440 what I would say is I would like to be 0:12:35.480 --> 0:12:39.280 in a place where we are endemic at relatively low 0:12:39.480 --> 0:12:42.760 rates of disease, where we have low rates of disease, 0:12:43.200 --> 0:12:47.120 high rates of vaccination, high rates of protection, and certainly 0:12:47.200 --> 0:12:50.319 low level of death. I also want to remind people 0:12:50.360 --> 0:12:55.160 that even with a vaccination, even for those um, even 0:12:55.200 --> 0:12:57.920 with vaccination, we have the capacity. Now we have new 0:12:58.040 --> 0:13:01.680 therapeutics and and even more science that continues to evolve, 0:13:02.120 --> 0:13:04.760 and some of those therapeutics can also, as I say, 0:13:04.800 --> 0:13:07.600 take the fangs out of this and really lead to 0:13:07.800 --> 0:13:10.560 less severe disease. So we have a lot of tools 0:13:10.559 --> 0:13:13.480 in the toolbox and working now to scale those up 0:13:13.520 --> 0:13:16.560 to make sure that everyone has access to them. Children 0:13:16.640 --> 0:13:18.959 under five still aren't able to get the vaccine, as 0:13:19.000 --> 0:13:23.200 you know, and I get this question constantly on social media. 0:13:23.760 --> 0:13:26.840 When will we see that approved? And does that give 0:13:26.880 --> 0:13:30.880 you pause? It all the idea of vaccinating children under five. 0:13:33.120 --> 0:13:37.200 You know the companies are working towards the timeline for 0:13:37.280 --> 0:13:40.120 children under five. I can't tell you exactly when that 0:13:40.200 --> 0:13:42.520 will be with a date certain, and I know parents 0:13:42.520 --> 0:13:47.320 are really anxious. Um when it happens through the f 0:13:47.440 --> 0:13:50.199 d A process through to the c d C process, 0:13:50.320 --> 0:13:53.080 I can tell you, Um, it won't happen with me 0:13:53.240 --> 0:13:56.800 at the helmet CDC unless all of that due diligence 0:13:57.000 --> 0:14:01.240 is done such that I would be comfortable allvaccinating any 0:14:01.440 --> 0:14:04.000 child that I would have that's under the age of five, 0:14:04.120 --> 0:14:07.320 so that I can that I can say. What I 0:14:07.400 --> 0:14:10.680 can say is we really need to work to vaccinate 0:14:10.760 --> 0:14:13.600 all those who are around our children under five, because 0:14:13.640 --> 0:14:17.359 we have seen time and time again that in households 0:14:17.360 --> 0:14:20.600 where you have two and three people vaccinated, you surround them, 0:14:20.680 --> 0:14:24.800 you you cocoon children under five um that they are 0:14:24.880 --> 0:14:28.280 less likely to get disease. And right now, you know, 0:14:28.400 --> 0:14:31.960 we have about fifty two per cent of our teenagers 0:14:32.280 --> 0:14:35.920 who have received their primary series, about twenty percent of 0:14:35.960 --> 0:14:38.840 our children between the ages of five to eleven. So 0:14:38.880 --> 0:14:40.400 we have a lot of work to do, and I 0:14:40.400 --> 0:14:44.440 would encourage parents to get their children who are eligible 0:14:44.680 --> 0:14:48.040 vaccinated so that we can really protect those who aren't 0:14:48.080 --> 0:14:51.600 eligible yet. A lot of people on social media also 0:14:51.640 --> 0:14:54.880 wanted me to ask you about the troubling cases of 0:14:55.160 --> 0:14:59.760 long COVID. Is the CDC collecting data on this. Many 0:14:59.800 --> 0:15:03.760 of those folks feel that they've been sort of abandoned 0:15:03.840 --> 0:15:08.840 by the medical establishment. Yeah, so we have a lot 0:15:08.920 --> 0:15:12.479 of studies that are ongoing at CDC, both a surveillance 0:15:12.600 --> 0:15:16.960 level as well as UM through electronic health records, and 0:15:17.080 --> 0:15:19.400 i AGE actually has quite a bit of funding to 0:15:19.600 --> 0:15:22.960 look at the manifestations and disease of long COVID and 0:15:23.040 --> 0:15:26.480 to try and understand how we intervene with long COVID. 0:15:26.560 --> 0:15:28.960 So there are many resources. The one thing I do 0:15:29.120 --> 0:15:31.720 want to say here, and I think it's really important, 0:15:32.440 --> 0:15:38.360 is that UM, you know, COVID hit UM disproportionately across 0:15:38.400 --> 0:15:40.920 the United States, and we've seen that. We've seen that 0:15:41.000 --> 0:15:43.880 in more vulnerable populations, We've seen that in racial and 0:15:43.920 --> 0:15:48.960 ethnic minority communities and UM. Because of that, that will 0:15:49.000 --> 0:15:51.800 have implications on who gets long COVID, and so I 0:15:51.880 --> 0:15:54.520 think we have a responsibility to make sure that those 0:15:54.560 --> 0:15:58.640 patients who were hardest hit by the original wave of 0:15:59.200 --> 0:16:03.960 waves of COVID nineteen that we worked to provide them resources, 0:16:04.080 --> 0:16:07.240 access to medical care. UM for those who have received 0:16:07.280 --> 0:16:10.040 long who have long covid UM. We don't have a 0:16:10.080 --> 0:16:12.960 lot of data yet on O macron and long covid 0:16:13.480 --> 0:16:16.920 UM because we certainly just certainly hasn't been with us enough. 0:16:17.000 --> 0:16:20.600 But we're talking to our international community. Those who have 0:16:20.640 --> 0:16:24.920 had COVID before US, South Africa, UK O, Macron before 0:16:25.040 --> 0:16:28.200 US South Africa and UK so that we can have 0:16:28.360 --> 0:16:31.720 sort of an earlier window as to what's happening there, 0:16:31.800 --> 0:16:33.840 and then we of course will continue those studies here. 0:16:35.480 --> 0:16:46.960 We'll be right back. I know this is a politically 0:16:47.040 --> 0:16:51.240 charged question, but it's still unclear how this virus started. 0:16:51.560 --> 0:16:54.920 No animal host has been found, and there are many 0:16:55.000 --> 0:16:59.080 critics who believe that this could have come from a 0:16:59.160 --> 0:17:02.560 lab in luhan On and it's somehow being covered up. 0:17:03.200 --> 0:17:07.960 What's your response to that, UM, you, I think it's 0:17:08.000 --> 0:17:12.080 an important question. Um. We may not be able to 0:17:12.119 --> 0:17:15.400 get to the bottom of that question. What I can 0:17:15.560 --> 0:17:19.800 say is that we have known many prior coronavirus, and 0:17:19.840 --> 0:17:23.160 I don't have insight into the truth behind that question. 0:17:23.840 --> 0:17:26.920 I think it it would be helpful historically and scientifically 0:17:26.960 --> 0:17:29.080 to know and understand it. I think we should do 0:17:29.160 --> 0:17:33.439 everything we can scientifically to understand it. I also know 0:17:33.680 --> 0:17:39.080 that historically coronavirus is whether they be stars or mirs, 0:17:39.760 --> 0:17:44.760 have traditionally come from an animal zooonotic source. So we 0:17:44.840 --> 0:17:48.960 have history that suggested the capacity to jump UM, but 0:17:49.119 --> 0:17:52.879 that is not just definitive for this virus, so you 0:17:52.880 --> 0:17:57.439 wouldn't rule out the possibility. I haven't had enough window 0:17:57.520 --> 0:18:00.359 into the science to to be able to say, and 0:18:00.400 --> 0:18:02.119 I don't know that we will ever be able to 0:18:02.160 --> 0:18:06.760 discern it. Tragically, it's been baptism by fire for you. 0:18:07.040 --> 0:18:10.280 Welcome to the world of being a public figure, Dr Willinsky. 0:18:10.320 --> 0:18:14.199 And there's been a lot of criticism of the CDC's 0:18:14.280 --> 0:18:18.680 public messaging. Looking back, what would you have done differently 0:18:18.800 --> 0:18:23.360 or what do you think the missteps might have been? Yeah, 0:18:23.440 --> 0:18:27.840 I think a lot about this. Um. First, let me say, UM, 0:18:27.920 --> 0:18:30.600 I came out and said I was going to lead 0:18:30.640 --> 0:18:32.840 with the science, and that is what I have done, 0:18:32.920 --> 0:18:35.399 and it has been my north star. I came from 0:18:35.440 --> 0:18:38.679 the bedside UM when I joined the CDC, and it 0:18:38.800 --> 0:18:41.320 is you know, the patients, every single one of them 0:18:41.359 --> 0:18:45.400 as individuals and collectively in public health, that drive how 0:18:45.440 --> 0:18:50.040 I make decisions. Um, that science during a pandemic is 0:18:50.119 --> 0:18:54.760 fast moving, and sometimes that science is gray, and you 0:18:54.840 --> 0:18:57.359 have to make decisions when you don't have all the 0:18:57.400 --> 0:18:59.919 perfect science that you would like because the situation at 0:19:00.040 --> 0:19:04.159 self is imperfect. I think given the curveballs that we've 0:19:04.200 --> 0:19:08.199 seen through this pandemic, much of what I might have 0:19:08.320 --> 0:19:12.080 done differently, is to say for now or UM, this 0:19:12.160 --> 0:19:16.240 could change or you know there there's much that we 0:19:16.280 --> 0:19:20.159 are continuing to learn because we have had to update 0:19:20.160 --> 0:19:22.800 our science as we've learned, as in our guidance, as 0:19:22.840 --> 0:19:25.959 we've learned new science, UM, and so much of that 0:19:26.040 --> 0:19:28.679 would have been Actually we need to continue to be 0:19:28.760 --> 0:19:31.560 humble as we learn more and more. A lot of 0:19:31.600 --> 0:19:35.720 people watching this, are listening to this are thinking, Okay, 0:19:35.880 --> 0:19:39.639 I mean, you hear about COVID fatigue everywhere. Dr Wilenski, 0:19:40.119 --> 0:19:43.160 I know you don't have a crystal ball, but when 0:19:43.160 --> 0:19:46.080 you look at the data that you currently have, when 0:19:46.119 --> 0:19:50.520 you hear Dr Falk say this will peak in mid February, 0:19:50.520 --> 0:19:54.160 when realistically do you think we might be able to 0:19:54.240 --> 0:19:59.639 get back to normal? UM. So let me tell you 0:19:59.640 --> 0:20:02.320 what I think normal looks like, and that is we 0:20:02.440 --> 0:20:05.600 talked a little bit about those our hospitals can manage 0:20:05.600 --> 0:20:09.880 patients coming in. UM. We are in a place where 0:20:09.920 --> 0:20:13.920 we can start enjoying UH activities that we once knew 0:20:14.000 --> 0:20:17.600 and loved. UM. I know everybody is interested in taking 0:20:17.640 --> 0:20:20.639 off their masks, and what I would say is we 0:20:20.640 --> 0:20:24.920 should manage the expectations that on you know, any given 0:20:25.000 --> 0:20:28.560 date certain that will be back to normal, because I 0:20:28.560 --> 0:20:32.800 think we're gonna tiptoe towards normal UM, and we'll increasingly 0:20:32.880 --> 0:20:37.840 over time, UM, providing that there is not another variant 0:20:37.880 --> 0:20:42.080 that throws us a curveball, increasingly over time be able 0:20:42.160 --> 0:20:46.119 to UM start peeling back all of those layers of 0:20:46.320 --> 0:20:49.720 protection that we have had UM. But I don't think 0:20:49.760 --> 0:20:52.560 that I think we should manage the expectation that on 0:20:52.600 --> 0:20:56.520 any given date we will be there. Finally, we ask 0:20:56.560 --> 0:20:58.879 you one other question, because you've been super generous with 0:20:58.920 --> 0:21:02.280 your time, but I think this is really important. I 0:21:02.359 --> 0:21:07.360 know that you believe this public health crisis has really 0:21:07.920 --> 0:21:11.560 shown a spotlight on the deficiencies and our public health 0:21:11.680 --> 0:21:16.000 system and how we need to bolster it. What do 0:21:16.040 --> 0:21:19.119 you think needs to be done so we're better prepared 0:21:19.640 --> 0:21:21.879 for the next I don't want to say this, but 0:21:21.960 --> 0:21:26.440 the next public health crisis, whatever that might be. Thank 0:21:26.480 --> 0:21:28.720 you for asking that question, because we have so much 0:21:28.760 --> 0:21:32.040 work to do. So over the last decade UM, we 0:21:32.119 --> 0:21:35.840 have had H one, N one, Ebola, ZEKA, and now COVID, 0:21:36.040 --> 0:21:38.880 and over that last decade there's an anticipation that we're 0:21:38.920 --> 0:21:43.200 now eighty thousand people in deficit in our public health workforce. 0:21:43.760 --> 0:21:45.960 So not only do we need the sheer volume in 0:21:46.040 --> 0:21:48.280 the number of people, but we need to scale up 0:21:48.280 --> 0:21:51.960 our workforce, upskill our workforce so that we have in 0:21:52.000 --> 0:21:56.440 any given community community health workers and genomic epithem neologists. 0:21:56.720 --> 0:21:58.399 So we have a lot of work to do in 0:21:58.560 --> 0:22:02.560 scaling up this gil UM and and share volume of people. 0:22:02.680 --> 0:22:05.200 Public health has to be an attractive place to enter. 0:22:05.400 --> 0:22:09.719 It's an incredible career UM, It's it's very other oriented 0:22:09.760 --> 0:22:13.200 and it's just incredible what you can do in public health. 0:22:13.600 --> 0:22:17.000 Our data systems have been frail, they have been untended 0:22:17.040 --> 0:22:19.520 to UM. We need to be able to have the 0:22:19.520 --> 0:22:23.240 pipes connect so that data from one state can easily 0:22:23.240 --> 0:22:26.240 communicate with data from another, that all can come together 0:22:26.640 --> 0:22:29.320 at c DC so we can compare different trends so 0:22:29.359 --> 0:22:32.600 that as you say, our region that's running into a challenge, 0:22:32.680 --> 0:22:36.120 we would be able to see UM quickly. And then 0:22:36.160 --> 0:22:38.840 we need to scale up our lab capacity or laboratory 0:22:38.840 --> 0:22:42.520 capacity at every different at every different jurisdiction and state, 0:22:42.840 --> 0:22:46.880 so that we have immediate capacity to detect challenges locally 0:22:46.960 --> 0:22:49.080 where they are. We have a lot of work to 0:22:49.119 --> 0:22:52.760 do in our public health workforce and in our public 0:22:52.760 --> 0:22:56.000 health infrastructure. And that's what I'm really trying and working 0:22:56.040 --> 0:22:58.880 and committed to be able to do um as we're 0:22:59.480 --> 0:23:02.480 sort of shining a light on where our deficiencies were 0:23:02.520 --> 0:23:05.520 coming in. It must be heartening for you to hear 0:23:05.640 --> 0:23:10.600 that applications to medical schools have skyrocketed as a result 0:23:10.680 --> 0:23:13.320 of this pandemic or increased dramatically. I don't know if 0:23:13.359 --> 0:23:17.439 skyrocketing is hyperbolic, but it must be heartening to you 0:23:17.480 --> 0:23:20.399 that many more people are at least applying to medical school, 0:23:20.720 --> 0:23:23.000 which is good. Is but some of those people need 0:23:23.040 --> 0:23:25.879 to go into public health when they graduate well, and 0:23:25.920 --> 0:23:29.000 I was one of them, so um so I do. 0:23:29.160 --> 0:23:32.400 There is an incredible pathway through medicine to public health. 0:23:32.440 --> 0:23:35.119 There's an incredible pathway through schools of public health, and 0:23:35.160 --> 0:23:38.760 really so many different pathways. And yes, it's really encouraging. 0:23:38.800 --> 0:23:41.720 I love talking to young people who want to who 0:23:41.760 --> 0:23:46.400 wanna have taken this moment really of this pandemic and said, actually, 0:23:46.400 --> 0:23:47.880 this is what I want to do now. They were 0:23:47.880 --> 0:23:50.480 moved by this moment. I was moved in my career 0:23:50.560 --> 0:23:53.719 by the moment of the HIV epidemic that was that 0:23:53.840 --> 0:23:56.679 was motivating so many of us to enter medicine at 0:23:56.680 --> 0:24:01.360 the time, and so um take this moment um and 0:24:01.359 --> 0:24:05.440 and uh work towards taking that incredible talent of these 0:24:05.440 --> 0:24:09.480 applicants and moving on towards public out. Dr Rochelle Wilensky. 0:24:09.600 --> 0:24:12.480