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Ex-Officials From Trump And Obama Administrations On COVID-19 Vaccine Efforts


The numbers are growing exponentially.


ANTHONY FAUCI: We have 10 million infections in the United States, almost 250,000 deaths. We've had 60,000 hospitalizations.

CORNISH: Tens of thousands of Americans are dead. Those critically ill are once again filling the country's ICUs. And as the United States heads into winter, dire warnings about the pandemic's toll are mounting.


FAUCI: We're also at this really dark time as far as the spread of this virus across our country.

CORNISH: But still a bright spot.


UNIDENTIFIED PERSON #1: Pfizer announcing that early data from its human vaccine trial has shown it to be more than 90% effective.

UNIDENTIFIED PERSON #2: Tonight, the biotech company Moderna says it has developed a vaccine that is nearly 95% effective.

UNIDENTIFIED PERSON #3: The second vaccine to show such high efficacy for getting us through this pandemic.

UNIDENTIFIED PERSON #4: We can see the light at the end of the tunnel.

CORNISH: But how does the country weather the gathering storm and get to the promised land of mass vaccination? Two questions we're going to put now to Scott Gottlieb, who's former head of the FDA under the Trump administration. He also sits on the board of vaccine maker Pfizer. And Andy Slavitt, who was the acting head of the Centers for Medicare and Medicaid Services in the Obama administration. Welcome to you both.

SCOTT GOTTLIEB: Thanks a lot.

ANDY SLAVITT: Thank you.

CORNISH: It's like you we've heard over and over what Dr. Fauci and Dr. Collins were saying yesterday, that this - we're heading into - the U.S. is heading into a dark winter, that hospitals are beginning to struggle. Looking at where things are today, this moment with the level of infection out there, how long of a difficult period are we looking at, Scott?

GOTTLIEB: I think it's probably going to last through end of January. I think we're not going to really see around the corner for the epidemic wave that we're seeing right now until the end of January. We're likely to see cases continue to build at least over the next six to eight weeks. If you look at the rate of transfer right now, the RT, it's about 1.15. So if we continue to have 1.15 to 1.20 new infections for every one infection that we have - and that's the rate of transmission that we're seeing right now - then we're probably going to infect another 15% of the population over the next three months. We've already infected probably 15% percent of the U.S. population. We did that over nine months. Over the next three months, we're likely to double the number of people who have been infected by this virus. And even if the infection fatality rate comes down substantially - and I believe it has - so if you assume an infection fatality rate of 0.45%, we're still looking at the potential for another 200,000 deaths as a result of COVID over the next three months. So this is a very dangerous period we're entering right now as we take this pathogen into the season when it's most likely to spread widely.


SLAVITT: I would just add to that that I'm particularly worried about certain communities, communities that have very small hospitals, small staffs in rural and outlying areas where they don't have as much experience treating COVID. I think you can see death rates that are much higher. Now, I want to end on a positive note by saying that the cases that we've seen to date are likely to be hospitalized, you know, around Thanksgiving and maybe - you know, be - we'll learn about the death rate by Christmas. But everything after that is still up to us. And we still have an opportunity. I know it's challenging for folks, but we still have an opportunity to affect what happens after that. And I think on behalf of all the nurses and doctors that are begging and pleading for a break, Americans can still do things. And it begins with the Thanksgiving holidays and with face coverings for a short period of time. And I think that's going to really help. And we need it.

CORNISH: You've both been in the position of advising administrations. What advice would you be giving the Trump administration or, more significantly, the incoming Biden administration?

GOTTLIEB: Well, look. I think the Trump administration is unlikely to change the strategy, which has been to largely leave decision making to the states. I think that when states do make decisions, we need to support them and respect the decisions that they make. If this is going to be a state-led, effort. We need to respect when states step in and make decisions. And Michigan made a difficult decision Sunday night to be one of the first states to take more targeted mitigation steps. With the Biden administration, I think they're going to be coming in at a time when we're going to be peaking. And we're going to be looking around the corner. And I think we need to look to, what can we open up safely? And how do we get support out to certain venues to allow them to open and stay open? And the first thing I'd be doing is trying to prioritize resources to schools so that we can have a spring semester for children. I don't see any reason why we won't be able to open the schools as we get past this current acute phase of the pandemic. But I think schools are going to need targeted resources to help them do that.

SLAVITT: Yeah, this is Andy. I think Biden - two tools that the vice president-elect can bring are competency and compassion. And he'll bring an experienced set of people that will help make sure that we're supporting states, local government schools and getting what they need. But he is also going to have to use the bully pulpit and tell people he understands what they're going through, that there is a light at the end of the tunnel, that he knows that people these days get their news from different sources and have different opinions but that this is an opportunity for us to pull together. I think the vice president-elect has an opportunity to use that bully pulpit, which has largely been empty over the last year. And I think that will be important to rally us all to do some good.

CORNISH: You've both served as de facto narrators of this pandemic since the beginning, using your social media feeds to issue warnings and predictions. Can I get, I guess, some thoughts from you on how we'll think of this moment when we look back a year from now or two years from now? Andy?

SLAVITT: You know, I think there's two measures that we're all going to have to wrestle with. One is just the blunt first line of the Wikipedia on COVID-19, which will be, how many people did we lose? And we need to do everything we can to save the next life for whatever happened before. The second is really going to be, I think, more of the oral history of this time, which is we'll get asked by our kids and our grandkids, what did you do to help? Whether it's helping someone who's lonely or has a mental illness, whether it's helping a nurse, whether it's just simply wearing a mask, you know, what was it that you did to help? Because it's an extraordinary time. And, you know, we've never had this kind of opportunity to save other people's lives like we do now. And we all can be a part of it. And I think it's something that when we get through, we all want to be a better part of. We're going to have to have a long conversation with - as a society when we're done with all of this, about all of the ways we could have done a better job at this. And I think those go not just to public health questions but to the kind of society we have and how we show up for one another.

CORNISH: Scott Gottlieb.

GOTTLIEB: Yeah, I think we're going to look back on this and recognize we weren't nearly as prepared to deal with this kind of a threat as we thought we were. We lacked the capacities to do it, the testing capacity, the capacity to scale up manufacturing. A respiratory pathogen posed an asymmetric risk to a Western democracy. We weren't able to implement respiratory controls in routine life. We were divided politically. And things like mask wearing and targeted mitigation, which we should've had a collective response to, became issues that politically divided us. And so I think we're going to recognize that we need to do much more to put in place better preparations for the future if we're going to guard against the next pandemic. And there will be a next pandemic. We always thought that the pandemic would be an influenza. The next one may well be a flu, and we're going to need to do better in terms of preparing the country for it.

CORNISH: Scott Gottlieb, head of the Food and Drug Administration during the Trump administration, now a fellow at the American Enterprise Institute - also serves on the board of Pfizer - thank you for speaking with us.

GOTTLIEB: Thanks a lot.

CORNISH: And Andy Slavitt, top public health official in the Obama administration, now senior adviser at the Bipartisan Policy Center, thank you for your time.

SLAVITT: Thank you. Transcript provided by NPR, Copyright NPR.

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