The CommonHealth

Helene Gayle sat down with us to reflect on the expert committee that she and Dr. Bill Foege led recently to map out – in record time – a framework and strategy for the phased introduction of a Covid-19 vaccine in America. For this urgent, complex priority, what are the principles that should guide decisions on who comes first, and who comes later? How best to address gross disparities in the vulnerabilities to Covid-19 of Black, Latinx and Native American populations? What are the essential steps to address widespread distrust and vaccine hesitancy? What comes next, how to navigate the uncertainty and turbulence of these times, and what are the roots of optimism and hope?  Helene Gayle is the President and CEO of the Chicago Community Trust. Previously she was the President and CEO of CARE, and a senior leader at CDC and the Bill and Melinda Gates Foundation. From July through October, she co-chaired with Dr. William Foege the Committee on Equitable Allocation of Vaccine for the Novel Coronavirus, organized by the National Academies of Sciences, Engineering and Medicine. Its final report, ‘Framework for Equitable Allocation of Covid-19 Vaccine,’ was issued October 2, 2020. Helene has been a CSIS Trustee since 2007.

Jennifer Kates and Josh Michaud, Kaiser Family Foundation, joined us to discuss their new analysis, ‘Distributing a Covid-19 Vaccine Across the United States – A Look at Key Issues.’ Getting vaccines to Americans is an unprecedented, gargantuan, complex enterprise. Just how ready are we? Financing thus far is a meager $200 million, while an estimated $6-10 billion will be required. Local public health infrastructure is rickety, insurance gaps are many, and building trust and engagement, especially with Black, Latinx and Native American populations remain essential challenges. Some states have identified early phase, prioritized recipients with some precision. Others lag behind. How to manage this enterprise amid deep partisan divisions, the winter surge, our national electoral process? How to judge the performance thus far of Operation Warp Speed? Give a listen! Jennifer Kates and Josh Michaud are with the Kaiser Family Foundation in Washington D.C.. Jennifer is the Senior Vice President and Director of Global Health and HIV Policy, Josh the Associate Director of Global Health Policy.

Mollyann Brodie, America’s premier health survey researcher, explores the widening bifurcation of America along partisan and ideological grounds, with “wildly different conceptions, wildly different sources of information, sealed off from alternatives.” This advancing politicization, aggravated by the current electoral cycle, is now dominating the response to Covid-19. She also walks us through the “perfect storm” experienced by the Black community in America, its compromised health and financial well-being, distrust and alienation from the health system, as revealed in a moving and powerful recent Kaiser Family Foundation/The Undefeated study. Mollyann Brodie is the Executive Vice President and Chief Operating Officer, Kaiser Family Foundation, where she also is Executive Director of the Public Opinion and Survey Research Program

In this episode, we are joined by Tom Bollyky of the Council on Foreign Relations. Co-director of a newly released bipartisan CFR Independent Task Force on pandemic preparedness and the response to Covid-19, Tom walks us through the Task Force’s findings, including how China’s lack of transparency in the early days of the pandemic fueled the spread of the virus, subsequently compounded by failures at the federal and others levels of the US government. Even in the midst of the Covid-19 pandemic, we need to prepare for the next ‘once in a century’ pandemic. Two Task Force recommendations stand out: its call for the creation of an international surveillance network coupled with a Health Security Coordination Committee, a new international mechanism to navigate geopolitical pressures and coordinate quick action.  Tom Bollyky is Senior Fellow for Global Health, Economics, and Development and Director of the Global Health Program at the Council on Foreign Relations. The report is the ‘Independent Task Force Report No. 78: Improving Pandemic Preparedness: Lessons From COVID-19’.

As UW-Madison opened in early September, it faced a sudden explosion of Covid-19 cases. Hear from Chancellor Rebecca Blank why this happened, the steps taken to re-stabilize the university amid multiple, deep political divisions across Wisconsin, a very public showdown between the university and county authorities, and a runaway Covid-19 outbreak in the state. Hear also about the impending return of football (“Every game is an away game!”), preparations for the winter and spring, the future of education at UW and beyond. “We have to respond” to achieve greater racial diversity among faculty and students as the movement for racial justice has swept the nation.  Rebecca Blank has served as Chancellor of the University of Wisconsin-Madison since 2013. Prior to that, she served as Acting and Deputy Secretary of Commerce in the Obama administration, Senior Fellow at the Brookings Institution, Dean of the Ford School of Policy at the University of Michigan, and as a member of the Council of Economic Advisors to President Clinton.

We crossed much sensitive and difficult ground in our extended conversation with Rep. Tom Cole (R-OK). President Trump’s bout with Covid-19, the proliferation of White House cases, the claim that the virus is not dangerous: how to make sense of all of this this, and the implications? Why have negotiations over the next Covid-19 emergency spending bill broken down? And how bad are the consequences? How to protect CDC and FDA? Do we need a national conversation on the value and merits of vaccines, and the need to rebuild popular trust and confidence? Should Congress support Gavi to bring vaccines to low and middle income countries? Give a listen. Rep. Tom Cole (R-OK) is leading force in Congress advocating for strong bipartisan US leadership in health security, at home and abroad. He is the former Chair and now Ranking Member of the Appropriations Subcommittee on Labor, HHS, Education and Related Agencies. He is Ranking member of the Rules Committee and Deputy Whip of the Republican Conference. He is also a member of the CSIS Commission on Strengthening America’s Health Security.

Our longstanding friend and ally Judyth Twigg joins us to survey the rather bumpy ride that America’s colleges and universities are experiencing as they navigate the pandemic. Are these institutions the new super-spreaders? What form of leadership is showing the best results? Are colleges and universities now the center for innovation in testing? How well exactly do we learn when separated into remote settings? What about mental health? Professor Judyth Twigg is Professor of Political Science at Virginia Commonwealth University and CSIS non-resident Senior Fellow with the Global Health Policy Center and Europe Program.

We sat with Chris Murray for an intense conversation on IHME’s recent, startling (and controversial) forecast that the United States would experience a dramatic surge in Covid-19 infections and deaths by year’s end that will exceed the peak moments of April. Many of the drivers are behavioral – a decline in mask use, rising mobility, lower vigilance and social distancing. But the seasonality is what will truly turbocharge the pandemic. Why is that, and what gives confidence that seasonality will be so powerful? Why do we as a nation appear stuck on a roller-coaster, incapable of learning to stick with actions that work?Chris Murray is Director of the Institute for Health Metrics and Evaluation (IHME) and Chair, Department of Health Metrics Sciences, at the University of Washington

In this episode, we learn from Richard Rossow, CSIS Wadhwani Chair in U.S.-India Policy Studies. India now ranks second in the world in Covid-19 cases, and in a single recent day recorded over 90,000 cases. What explains this dramatic, startling surge that we are witnessing? And how to reconcile that with the Modi’s government’s continued determination to reopen society and the economy? And his continued high public standing? And how does this relate to India’s special place in the world in production of generic vaccines? Richard Rossow is a senior adviser and holds the Wadhwani Chair in U.S.-India Policy Studies at CSIS.

We gather to discuss with Dr. Heidi Larson about her new book, Stuck: How Vaccine Rumors Start – and Why they Don’t Go Away, a wake-up call and appeal to re-think what drives popular distrust in science and rising levels of vaccine refusal and hesitancy. As the world strives to develop safe and effective vaccines to arrest the Covid-19 pandemic, we should expect widespread resistance. How should our understanding of rumors, risks and uncertainty, digital wildfires, and group think figure in our thinking? Popular trust in vaccines and authority have national security implications, given the urgent, huge stake in getting control of the pandemic and restoring economies: what might that mean? What type of engagement is most needed and appropriate today, if we are to avoid repeating the mistakes of the past? Dr. Heidi Larson is Professor of Anthropology, Risk and Decision Science and Director of the Vaccine Confidence Project at the London School of Hygiene and Tropical Medicine.