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Who's Bill This Time


This summer something weird happened in the Southern Hemisphere. Well, technically, it was summer here, which means it was winter down there. Anyway, their flu season starts in May or June, and because countries there were worried about the one-two punch of coronavirus and the flu, they stocked up on flu shots.


SYLVAIN ALDIGHIERI: The countries took it very, very seriously. They bought more vaccine and they vaccinated more people during the pre-flu season.

MCEVERS: Sylvain Aldighieri is the incident manager for COVID-19 with the Pan American Health Organization. He told NPR despite all these flu shots - or, as he says, vaccines - for the last few months, southern countries have been waiting for the flu to hit, but that never happened.


ALDIGHIERI: Now we are well advanced during the flu season in the south, and we have not seen any spike, any upsurge of flu.

MCEVERS: The flu hasn't totally disappeared in the Southern Hemisphere, but it is way, way down. For example, over a three-week period in the middle of winter in Chile, more than 3,000 patients with flu-like symptoms were tested.


ALDIGHIERI: And zero tests were positive for influenza.

MCEVERS: Now, what might be happening is that the combination of the flu vaccine push plus the mask-wearing, the hand-washing and the social distancing is limiting the spread of flu down there. But there are also some key differences between there and here. Winters in the south are generally milder than they are here. In America, in places like the Midwest and Northeast, people will spend a lot more time indoors. And the coronavirus is just more widespread here than almost anywhere else. Coming up, a new adviser in the Trump administration who scientists are worried about. This is CONSIDER THIS FROM NPR. I'm Kelly McEvers. It is Thursday, September 3.


MCEVERS: This is CONSIDER THIS FROM NPR. So scientists are trying to figure out what it means if someone gets the flu and the coronavirus at the same time. There are a couple dozen reports of that happening in countries around the world - patients who tested positive for both viruses - not a ton of cases in the grand scheme of billions of people around the world, but still...


MICHAEL MATTHAY: It's quite possible and likely that the two viruses could infect a patient at the same time or, for that matter, sequentially - one month, one virus, and the next month, the other virus.

MCEVERS: So experts say the best way to not worry about all this is to get a flu shot. It'll help protect you from getting the flu, and...


LJ TAN: If you get vaccinated and then you catch influenza, the data's clear that you will get a much less serious case of flu.

MCEVERS: L.J. Tan is chief strategy officer at the Immunization Action Coalition. This year, with people less likely to want to visit their doctor, companies are going to pitch you on flu shots at drive-through clinics or curbside tents. Tan says the goal is to make it easy and convince people they need the shot, especially people who are at risk.


TAN: They tend to be over 60. They tend to have chronic heart disease. They can have chronic respiratory illness. And so I think one of our things is that if you look at that and you overlap that against the high-risk populations for flu, they're almost identical.


MCEVERS: What happens with the flu will affect what happens with the pandemic in the coming months. So will the development of a vaccine. This week you might have seen in the news that the CDC actually told states to prepare to distribute a coronavirus vaccine as soon as October.


MONCEF SLAOUI: There is a very, very low chance that the trials that are running as we speak could read before the end of October.

MCEVERS: That's Dr. Moncef Slaoui. He should know. He's the chief scientific adviser for a project called Operation Warp Speed. It's the U.S. federal government program to develop and distribute the vaccine. He told NPR today basically, the government did tell states to get ready next month but did that just to get them prepared. The more likely timeline for a vaccine, he said, is the one we have heard many times before - end of this year at the earliest. And even then, any vaccine would go to people who are most vulnerable first.


SLAOUI: Which means very old people - I would say 70 years old and older - and maybe people that are highly exposed in the first line.

MCEVERS: For the rest of us, Slaoui says if a vaccine goes according to plan, it'll be the middle of next year. More from his interview with NPR is in our episode notes.


MCEVERS: So, yeah, a vaccine is pretty much a waiting game. But the Trump administration seems to be more and more focused on a vaccine and less on the advice of public health experts, which brings us to a new adviser in the Trump White House. He has no background in infectious diseases, and his ideas are worrying scientists who do. His name is Dr. Scott Atlas, and two NPR reporters - White House correspondent Tamara Keith and science correspondent Geoff Brumfiel - have been looking into what he's doing and how he got to the White House. They talked to my colleague Mary Louise Kelly.


MARY LOUISE KELLY: So who is Dr. Atlas? Let's start with his background, Geoff.

GEOFF BRUMFIEL: Well, he was a radiologist at Stanford. And according to folks who've worked with him, his scientific expertise is really around medical imaging - so you can think about, like, MRI machines, CT scanners, things like that.

KELLY: Not viruses.

BRUMFIEL: Not at all.

KELLY: Yeah.

BRUMFIEL: And, you know, in the early 2000s he joined the Hoover Institution, this right-wing think tank over at Stanford. And he's focused mainly on health policy, and in particular, he's been critical of Obamacare. And he's promoted free market solutions to America's health care issues.

TAMARA KEITH: And after the outbreak started, he became a Fox News regular, attacking the lockdown, saying America needs to reopen; kids should go back to school - in short, the very message that President Trump has been delivering from the White House since around April. And that seems to be - Fox News, TV, talk radio - that seems to be where Atlas caught the president's attention.

KELLY: Yeah. We've actually got a little bit of tape of him talking on talk radio. This is Scott Atlas back in April. He was on "The Steve Deace Show." That is a conservative talk show.


SCOTT ATLAS: Those who are not at risk to be - to die or have a serious hospital-requiring illness - we should be fine with letting them get infected, generating immunity on their own. And the more immunity in the community, the better we can eradicate the threat of the virus.

KELLY: Geoff Brumfiel, he says we should be fine with letting them get infected. Am I hearing that right? Is he saying some people should just get sick with COVID?

BRUMFIEL: Yeah. So again, this was back in the spring. But he was advocating for an approach that's called herd immunity. And the idea is that if the virus infects enough people and those people are then immune, it will kind of end up running out of places to spread and burn itself out. Now, Atlas doesn't want to open up completely. He's advocated for letting the virus spread in the population while isolating the oldest and most vulnerable Americans so that they don't get sick and die.

KELLY: What do other doctors, what do public health experts have to say about this?

BRUMFIEL: They say this is an incredibly dangerous and risky approach. First, it's very difficult to isolate one group of people from society, especially when you consider the CDC estimates about half of the American population has some kind of risk factor for COVID complications. It's not clear how you just wall those people off.

And then the second problem is COVID can make young people really sick even if it doesn't kill them. So CDC data indicates roughly a third of COVID patients from 18 to 34 suffer long-term health effects. There's also reports of strokes and more serious complications, though the data isn't quite clear on how common that is. So you talk to a public health expert like Ashish Jha at Brown University, and he's going to tell you it doesn't matter how old you are. People should not be getting COVID, period.

ASHISH JHA: I'm not so cavalier as to say, it's fine. You might have long-standing lung damage. You might have long-standing heart damage. But hey, at least you won't die. It's OK.

BRUMFIEL: Now, I should say, in a statement to NPR, Dr. Atlas has said that he never advised the president - he hasn't advised officially the pursuit of the herd immunity strategy.

KELLY: Tam, fact-check that for us. Do we know if that's true? I mean, there are other ways of influencing the president without directly advising him to do something.

KEITH: Yeah. What I can tell you is that if you listen to President Trump talk, he is mirroring Atlas' language very closely. Remember back to the clip we played of Atlas. Now listen to what President Trump said at the White House briefing last month. He said you shouldn't focus on how many people come down with COVID.


PRESIDENT DONALD TRUMP: Far more important is who the virus is infecting. That's why our strategy and attention are focused on preventing the cases that are most likely to require hospitalization or result in death.

KELLY: Tam, just dig into this a little bit. What is it that President Trump is hearing in Dr. Atlas' approach that he likes?

KEITH: It validates President Trump's impulses on how to handle coronavirus. Atlas puts a lot more emphasis on the economy and the mental health value of returning to normal than the infectious disease experts that have been around the White House and advising the White House. Yeah, experts like Dr. Birx and Dr. Fauci - their focus has been on containing the disease. And now Trump has someone with a doctor in front of his name who can help him push his idea that things need to get back to normal even before there's a vaccine. The way a White House spokesperson described it to us is that Atlas' role is integrating medical science and health policy. And then the person added, quote, "We already have health and infectious disease experts."

KELLY: To that point about the push to get things back to normal, I think a lot of us would like to get things back to normal. Geoff Brumfiel, we are in the midst of not just an unprecedented public health crisis, but an economic crisis. Businesses everywhere are still shut. Schools are closed all over the country. Is there an argument that policymakers do need to be thinking about more than just public health, more than just the science?

BRUMFIEL: So here's the thing. I mean, this is really about lockdown - shutting down schools and the economy. Public health people - they don't want these lockdowns. Ashish Jha of Brown University - he told me the solution isn't to let this virus run out of control.

JHA: Actually, the way you improve the economy is by controlling the virus. That's what we have seen in other countries. South Korea's economy is doing much, much better than ours because they control the virus.

BRUMFIEL: And you know, when you don't control the virus, what happens? You get a surge. Right now in Europe, in France and Spain, we're seeing spikes in COVID cases because they opened up so quickly. So there's economic risks to opening and ignoring public health.

KELLY: Well, let me circle us back to Dr. Scott Atlas. And I suppose the big question on my mind is, how influential is he? How much access does he have to the president and his thinking? Tam.

KEITH: Yeah. I called up conservative economist Stephen Moore, who has advised the White House through the pandemic and also before. And he said that Atlas is an influential voice in the White House these days.

STEPHEN MOORE: His voice is - and I think I speak for a lot of, you know, free market people who've been really frustrated by the lockdowns - that his voice is really very welcome, you know, combating some of the nonsense that comes out of Fauci. So I think he's a real asset for the president.

KEITH: As far as Fauci goes, he was asked yesterday about the concept of herd immunity on MSNBC, and he emphasized that it is not the approach he is taking, nor Dr. Birx, nor, quote, "any of the other people that I know on the task force." There was a meeting of the coronavirus task force yesterday. The White House posted pictures afterwards, and both Fauci and Atlas were there in the room.

MCEVERS: Tamara Keith, who covers the White House, and Geoff Brumfiel, who covers science for NPR, talking to my colleague Mary Louise Kelly.

This is CONSIDER THIS FROM NPR. I'm Kelly McEvers. Transcript provided by NPR, Copyright NPR.

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