The CommonHealth

Yasmeen Abutaleb, health policy reporter at The Washington Post, joins Steve Morrison and Andrew Schwartz for this 136th episode.The Biden administration struggles on multiple fronts, from systemic dysfunction within agencies to increased polarization of virtually every measures to mitigate Covid-19. The administration wants to invest in a long-term vaccine strategy that protects against multiple variants in advance -- but lacks the resources. Omicron taught us:  "You can't start buying stuff when the wave has started.” "The disinformation problem is so widespread"  that "… everyone in the Biden administration is going to be distrusted by half of America." The US government has not staged a powerful Covid-19 messaging campaign on social media, and a national commission on the pandemic, with real bipartisan leadership, remains out of reach.  Courts are exercising considerable sway over health security policy which require a careful political calculations. Would appealing federal Judge Mizell’s April 18 injunction against the national mask mandate on transport ultimately leave the CDC in a weakened position? Americans continue to experience the pandemic in vastly different ways, depending on socio-economic profile. Many who have protections through vaccines and treatments may feel they will be exempt from infection, yet they make up a significant share of those experiencing severe illness. 

Dr. Dylan George is the Director of Operations for the Center for Forecasting and Outbreak Analytics (CFA), newly established at the Center for Disease Control and Prevention (CDC). Dr. George joins J. Stephen Morrison and Andrew Schwartz for this 135th episode following the April 19th White House CFA launch. Its mission: Predict, Inform, Innovate. Its data science team will strengthen advance warning of biological emergencies, with a heavy emphasis on improved communications. Building trust is a major challenge, including navigating privacy sensitivities. Sustained funding is essential, and an outstanding question. If successful, CFA will provide the tools people need to keep their families safe while improving decision-making at the local, state, and federal levels. Like extreme weather communications, CFA will make complex models accessible.

Dr. Larry Gostin is a professor of global health law and the faculty director of the O’Neill Institute for National and Global Health Law at Georgetown University. Dr. Gostin joins Steve Morrison and Andrew Schwartz for this 134th episode in the aftermath of the April 18 nationwide injunction to block government mask mandates on public transportation. In Judge Mizelle’s opinion, the C.D.C. has exceeded its legal authority. But if the C.D.C. doesn’t have the power to make someone do something as unintrusive as wearing a mask, what can it do? If this ruling stands, it changes the role of the government, and our regulatory institutions will lose the power to protect us. The C.D.C. has been in a weakened position since the Trump administration but is staffed by strong scientists who want to do their best for Americans. Dr. Gostin argues for a High-Level Commission to take a top-down and bottom-up review of the C.D.C. to determine what systems, data, scientists, funding CDC needs, and what powers are legitimate. He does have hope: the U.S. is approaching higher levels of immunity, and the darkest days of the pandemic may be behind us.

Dr. Yanzhong Huang is Professor at Seton Hall University's School of Diplomacy and International Relations, Senior Fellow for global health at the Council on Foreign Relations, and co-chair of the US-China Working Group of the CSIS Commission on Strengthening America’s Health Security. He joined Steve Morrison in the our 133rd episode for a wide-ranging conversation: on China’s huge immunity gap; its “dynamic Zero-Covid approach;” the spread of BA-2 beyond Shanghai to 45 cities affecting 25% of China’s population and 40% of its GDP; the acute vulnerability of China’s elderly; and the supply chain disruptions and huge economic consequences experienced inside China and, increasingly, felt across the globe. Deaths are underreported, and popular discontent has risen, even while it remains doubtful that majority opinion has shifted against Zero-Covid.While the Chinese government has made some modest adjustments to its fierce reliance on mass lockdowns, testing and quarantining, it has not fundamentally changed course. “Zero-Covid will continue.” Opposition is at the highest level -- at the Presidency itself: “the barrier is political.” It remains unclear when if ever the government will move to a mass campaign using a Western mRNA vaccine, a key step to creating immune protection and easing reliance on lockdowns. Successful development of a Chinese mRNA vaccine has thus far been elusive. 

Dr. Beth Cameron, Special Assistant to the President and Senior Advisor for Global Health Security and Biodefense at the White House, joins Steve for Episode #132. The Biden administration is making progress on the Global Health Security and Pandemic Preparedness Fund, envisioned as a Financial Intermediary Fund at the World Bank. The fund will invest in a globally linked bio-surveillance and early warning system, aid to the most vulnerable countries to build their health security, and rapid research and development in regulatory systems to create, rapidly scale, and distribute medical countermeasures. We need to "finish the job" and get out of this phase of the pandemic and need truly global surveillance systems and stronger information sharing to prevent the next biological threat. The second Covid-19 Summit has been announced for May 12, with the dual goals of ending the acute phase of the Covid-19 pandemic and strengthening preparedness for variants and future pandemic threats.

The Washington Post's Dan Diamond returns for Episode #131. Public attitudes towards Covid-19 have changed, and the pandemic has become a lower political priority. "It's been a steady saga of lack of action compounded by different political priorities swamping Covid." Midterms are coming up, and candidates want to show that there are other issues they are attentive to: inflation and crime. Republicans argue that there are a lot of unused emergency funds, and there needs to be better rigor and transparency in their use. But money is urgently needed to go to reliable partners. Anecdotally, it feels like Washington, DC is experiencing a wave, but it isn't reflected in the data–people aren't reporting their results, so we've lost some awareness of our surroundings. There are disincentives for politicians to speak about the pandemic across partisan lines, and we've relaxed all of our mechanisms in place to help us stay vigilant. This has been a long pandemic, and Americans are exhausted. Dr. Ashish Jha inherits a new set of challenges, and a new set of opportunities to build on the achievements of his predecessors in his new role as the White House Covid-19 Response Coordinator. He is talented in messaging but has never held a full-time government role before. How will he adapt to these new challenges?Dan Diamond is a national health reporter for The Washington Post, focused on accountability, federal agencies, and the coronavirus pandemic.

Dr. Matt Hepburn of the White House Office of Science and Technology Policy joins Steve and CSIS Senior Associate Tom Cullison for this 130th episode. Beginning as an Army infectious disease researcher and DARPA project manager, Dr. Hepburn’s visionary leadership was instrumental in the rapid availability of Covid vaccines through Operation Warp Speed. The world continues to face catastrophic consequences with the highly contagious BA2 variant. Hong Kong, Singapore, South Africa, and others are in the midst of spikes, while China wrestles with the strong likelihood of widespread outbreaks. Africa is largely unvaccinated, adding Covid to the list of diseases that burden the continent. Although he suggests summer will not save the United States from another surge, Dr. Hepburn remains positive. He’s posed seemingly impossible challenges like “let’s create a vaccine against an unknown disease in 60 days”, then won over skeptics by creating a solution. “We have to change the culture of our government to escape the cycle of crisis and complacency”

In this 129th episode, Steve joined in frank conversation with University of Wisconsin-Madison Chancellor Rebecca Blank as she approaches the conclusion of a nine-year tenure that dramatically tested her leadership and the university itself. There is considerable progress -- an increased graduation rate, shorter time to graduation, student debt reduction, improved diversity. The financial foundation of the university’s $3.6 billion budget has been systematically strengthened, through innovative fundraising and new partnerships with the private sector. But those gains are fragile, the university faces fierce competition from its peer institutions, serious financial and governance challenges persist, and changes in culture are difficult and require time. Worsening political polarization in the state is quite problematic. The university finds itself a “pawn” in partisan battles, and Republican legislators lag far behind in supporting sustained investments in the university. Covid-19 remains a live matter – it is not over – but the university has built better systems – ventilation, testing, vaccination, safety protocols, hybrid instruction – and created trust and commitment within the university community. Even without a vaccine mandate, the university achieved 96% vaccination coverage. The university responded to the shock of rising racist incidents and the drive for racial justice, in the aftermath of George Floyd’s death. Most significant has been changes in the recruitment and retention of students, faculty, and staff. Much work still remains: UW remains predominantly White in a predominantly White state.

Two years later, Dr. Richard Hatchett, CEO of the Coalition for Epidemic Preparedness Innovations rejoins Steve for the second iteration of our Live From Munich mini-series. Dr. Hatchett reminds us that having just had a pandemic does not prevent outbreak from another, and that pandemic preparedness needs to be “viewed as a security challenge, not as a health challenge, not as a development challenge”. He points to lessons in vaccine manufacturing and financing arrangements that incentivize disease surveillance that can better prepare us for the next pandemic. “Many of the high-income countries see the value from a geopolitical and security perspective in making these investments. The challenge for the long term, obviously, will be whether these facilities can be successful, sustainable, and be sustained.”Richard J. Hatchett, MD, is Chief Executive Officer of the Coalition for Epidemic Preparedness Innovations (CEPI).

In this 127th episode, an edited version of a live event recorded on March 2, Scott Kirby, CEO of United Airlines, joins Steve for a fireside chat. Scott Kirby has been a health security leader in the private sector, achieving a 99.7% employee vaccination rate in eight weeks. The Covid-19 pandemic forced a major change in internal culture “about leading, about doing the right thing, about a customer service culture that didn’t really exist before”, including abandoning some policies like flight-change fees. After getting news of the second Covid-19 related employee death, he decided to implement the mandate “just because its the right thing to do”. Despite pushback, he does not regret it: “Saving lives? There’s never a decision I’ll make in my career that is as important as that one, or one I’ll ever feel as good about”. This change in company culture extends to climate change too. United is going green by 2050 with sustainable aviation fuels for long flights and investing in electric and hydrogen solutions for short flights. They have also partnered with Occidental Petroleum Corp to invest in carbon capture sequestration, which will offset United’s annual emissions without traditional carbon offsets.  Scott Kirby is the Chief Executive Officer of United Airlines Holdings, Inc.