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tv   COVID-19 Forecast for the Holidays and Beyond  CSPAN  November 29, 2021 8:01am-9:03am EST

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my name is anand parekh and on the chief medical advisor at the bipartisan policy center and i want to welcome you to today's event entitled covid-19, forecast for the holiday and 2022. today's event is part of a series of activities at the bipartisan policy center to help inform the public and policymakers of the response of covid-19. recently, our future of healthcare task force released a report with recommendations were there to immediate action that the biden administration and congress need needed to tao tackle covid-19. they also released a report focus onti positioning the publc health system for the next pandemic. today's event is two parts. the first part is a recently recorded fireside chat between dr. tony fauci, president biden's chief medical advisor, and director of the national institute for allergy and
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infectious diseases, and snore bill frist, former senate majority leader and bpc senior fellow. after that pre-recorded conversation i will moderate a discussion with dr. leana wen, visiting professor at george washington university and former baltimore city commissioner of health, and doctor jerome adams, executive director of equity initiatives at purdue university, and former u.s. surgeon general. following that moderated discussion we will make sure to get to some questions from all of you, so please feel free to enter your question into the chat or engage with us on twitter, #bpclive, and handle bpc underscore bipartisan. without further ado and with that introduction i will now turn over to snore bill frist whost would get the program started. thank you. >> thank you for that introduction into the bpc for its important efforts. i'm excited to be sitting down
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today with my longtime friend and colleague dr. anthony fauci. tony, it's great to be with you once again. >> thank you, bill. good to be with you. thank you for having me. >> tony we don't have a lot of time today so let's jump right in. let's start big picture. what is your overall impression of how we are doing as a country right now with respect to covid-19? ttle bit of a mixed bag. let me explain. we went through a significant surge, which has come back down and the deflection of the curve looked good. the surge was related to the appearance of a delta variant, which is a very formidable virus in that it transmits very, very efficiently. the vaccination program has worked quite well in many respects. so we have been able to turn that around. the only thing that the little
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bit disconcerting is that we are beginning to plateau. in other words, the deceleration of cases is now plateaued and in some areas of the country, we are starting to see a bit of an uptick. with regard to vaccinations, although we have done well in many respects, we have 85% of our elderly individuals fully vaccinated and 98% with at least one dose. we have 75% to 80% of adults have received at least one dose, but we still have about 60 million people in the country who are eligible to be vaccinated who have not yet gotten vaccinated. that is excluding the 28 million children from five to 11 who we have recently now have authorization and recommendation to vaccinate. there is a lot of good news but some challenging news that we really need to address as we go
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into the winter months. senator frist: tony, as we look in the crystal ball, jumping ahead to 2022, we're clearly still in pandemic now. when will we evolve to more of an endemic environment and also a little bit, what is an endemic environment? what can we expect in 2022? dr. fauci: let me start with your question about the definition. so endemicity, it's not very dramatically impacting everything we do, which it has. that's not only us. that is the entire rest of the world. when you have a deceleration and you get below the pandemic phase, that means the virus is still present but it is not overwhelming the system of health care. it is not disrupting our normal social interactions and our economic interactions but it has
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not disappeared. the trick is, what level in that bracket of endemicity are we going to wind up at? are we going to be at a very low level where we barely even notice it -- sort of like the sort of infections in the community that are there that makes a few people sick but it does not impact what we do or is it going to be a high enough that we are always going to have to be careful we are going to get a resurgence? obviously, the optimum would beget so low that we can start to really return to what we feel is as close to normal as we can. when we get there, apropos of your first question is going to depend entirely on us. how well we vaccinate the public. how well we get boosters to people. because we know that the vaccine efficacy clearly wanes. we know that from our own
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country. we know that from more intense experience in israel. if we can get most of the people who are eligible to be boosted booster, we can go a long way to making 2022 much more of a normal year than what we have seen in 2021. senator frist: tony, you really touched upon it but the introduction into the equation of children, we have vaccinated people eligible for boosters. have unvaccinated adults. how did the children age five to 11 add to the equation? dr. fauci: well, there's 28 million children in that age group. it is absolutely true that children who get infected generally do not get a serious disease as an adult, particularly in elderly adult. but as we know, children are really quite susceptible to being infected even though about 50% of them get no symptoms.
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you still can have some serious illness. there have been about 2 million children from five to 11 who have been infected. there have been anywhere between 65 and close to 100 deaths among that group. over 8000 hospitalizations. it is not a trivial disease in children, but also, given the size of that cohort, to get them protected would have an impact on the dynamics of the outbreak. the clinical trials have been pretty clear. the efficacy in children five to 11 is 91% with the mrna pfizer vaccine and the safety profile is really quite good. senator frist: let's look global , and issue you and i worked on 20 years ago was pepfar, and that has been a signatory example of strategic health diplomacy.
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the idea that the united states should work and help other countries because it is the right thing to do morally from a health standpoint, from a national security perspective. in that same vein, what more needs to be done with respect to covid-19 internationally? and what is our responsibility as a country in your opinion? dr. fauci: bill, i haven't changed in my strong feeling that you and i shared as you say, 20 years ago. when we were putting together the pepfar program. i believe we have a moral responsibility as a rich nation to be able to extend ourselves and get interventions that are lifesaving to those low and middle income countries that do not have the resources to do it themselves. what are we doing? we have either given or pledged
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now 1.1 billion doses to low and middle income countries. we have given and/or pledged up to $4 billion to covax. and importantly, we are working with the pharmaceutical companies to greatly increase their capacity over and above the demands for our country and others so that we can eat centrally get -- we can essentially get doses to the tune of billions of available to the developing world. the united states, and i know everyone looks to the united states for how we are doing, we are doing more and getting more doses to the rest of the world than all other countries combined. but that is not for us to stop doing what we are doing. we need to do even more. we know for sure as a nation and president biden is behind this, to continue to do what we can
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for the developing world. senator frist: tony, as we look ahead, again this was a little bit after the beginning of pepfar, but 15 years ago we are writing a lot and talking about pandemics and inevitablity of pandemics. jump ahead 15 years and that is to today. what are the most important elements based on our recent history of pandemic preparedness that now looking forward that we forward that we must redouble our efforts on? dr. fauci: well, we certainly have to use these very painful lessons over the last 20 months, not only to respond better to where we are in the midst of a pandemic, but to even as we do that to put into place plans for pandemic preparedness for the future.
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we did that right. what we did not do as well was public health preparedness. we tried to have the public health global strategic security agenda. yet we didn't really get that to the level where it should be. our own country, domestic public health infrastructure over the years has actually been subject to attrition where public health leaders retire and are not placed. public health infrastructure is not modernized. we need to do that much better.
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we also need to collaborate with countries throughout the world, because as we know now and are painfully witnessing, a global pandemic requires a global response. and a global response requires global preparedness. that's what we are looking forward to right now and over the next couple of years. senator frist: tony, your perspective has been just monumentally important over the last two years, last 20 months or so. as we have looked back the public's attitude towards science has changed so much. we don't want to say everything is political and partisan and the like, but the attitude towards science has changed. back when i was in the senate, we -- it was republicans, under
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republican leadership we doubled the n.i.h. funding, then we jump a few years ahead it seems back a lot of those seem people today are questioning science. it's become this more partisan divide on science. brown university has attributed to this in part not having enough conservative voices within public health. i don't want to go into the political direction, this distrust of science and partisanship, any comments? dr. fauci: oh, yes, bill. it is really disconcerting. and we are seeing it so clearly now. i think if you were back in the senate right now, you would be having a lot of heartburn, i can tell you. because what we are seeing is a public health issue which requires sin energy among all elements of our government where we realize that the common enemy
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is the virus. sometimes when you listen to people speak, it's almost the enemy is each other. and we have public health decisions that are based on ideologic considerations. you should never have that. you should never have looking at a map and seeing that people who are vaccinated fall heavily into one group and people unvaccinated fall heavily into another group. that is so antithetical with what public health should be. which should be a concerted effort on the part of the entire population. so you are right, there is an anti-science element right now that has a very strong political twinge to it, which is very, very disconcerting. i hope that when we get ourselves out of this, people will look back and realize, we don't ever want to do that again because it really hindered our response to this pandemic.
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senator frist: the fact that the big, not miracle, but you implied it a bit ago, a lot of the research we got right, the fact that the government and private sector have been able to come together to make a vaccine in a year, which both you and i thought was impossible four or five years ago, will that help when your average person says i'm alive today and my family is healthy because of the great science out there? will that help, you think, in terms of building a broader constituency for science? dr. fauci: i think it can and will. but we have to do a better job of communicating that because many people, instead of marveling at the speed with which we were able to do something in an unprecedented manner, you have the opposite. people say, well, you did it so quickly, you must have been cutting corners. instead of trying to realize the
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beauty of the investment of resources and science that went way back to when you were in the senate. i mean, the amount of support that you and your colleagues were involved with 20 years ago in getting the n.i.h. the resources was exactly the reason we were able to move so quickly. so it was a belief in science that has gotten us here. we have got to get that message back on the front burner to the american people. senator frist: i don't want to keep going to the past. you pulled it off. our government pulled it off back with hiv-aids with pepfar. we had huge bipartisan support. all built on science. i remember that president bush sent you down to africa, didn't send you there, you went, you came back and said yes, this is doable.
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it's going to take science. everybody coming together. sure enough we took it on. it ended up being bipartisan. trusting science. and there are probably 20 million people alive today because of that. the fact we know it can be done, it's getting back to it. communication, i want to ask how you're doing, before i ask that, because you have been in the middle of this, applauded by most, criticized by some, but communication when we were addressing it 2005, 2006 all of us said, that's probably the number one thing we need to get right. i'm not sure any of us got it right now. just comment on the importance of communication in the time of crisis, especially when we all don't know what the future is going to be. there is anxiety. people are frightened. how important is this whole communication? also how can we do it better next time around? dr. fauci: it is absolutely critical to everything we do. is to get the facts out to people, get them to really
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understand the nature of science. because there are many people understandably who think that science is absolute and never changes. when you know and i know that science is self-correcting. as the outbreak evolved, we got more and more important information which fashioned our response, our recommendations, our guidelines. how we approached the outbreak. we have to be able to communicate to people to understand the nature of science. i think that would be greatly helped if in the big picture of things we put a lot of emphasis on science literacy and got more of our younger people interested in at least understanding science. not everybody can or should be a scientist, but most people
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should at least understand what it is. i think if we had more of that, the communication would have been much smoother. it goes both ways. senator frist: that i think, the communication whether in medical schools or schools of public health, we all can do better, those of us who are on the inside in terms of communicating. you are exactly right. improving k through 12 education so we can understand the basics of science. there are going to be more and more science coming toward us every day. how are you doing with it? i don't want to overly humanize this discussion, but it's got to have been incredibly intense for you, the demands and the ongoing demands. how are you doing? dr. fauci: you know, i'm doing fine, bill. i have been doing this a long time. my secret is to focus like a laser on what my job is and what our goal is. and my goal, as you know, you
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have known me for many years, is the health and safety of the american public. against all health threats. be they the chronic illness that is we have, or the emerging infections that we have to face. one of the things that is a bit disconcerting, obviously, is that we've never had this before where the -- because i'm representing science, i get attacked. that's an attack on science. who would have imagined when you and i were working together that i would have to have federal agents guarding me all the time because of attacks and threats on my life, harassment of my family, my children, my wife. merely because i'm telling people they need to get vaccinated. merely because i'm telling people they need to wear a mask. can you imagine that, bill, it
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doesn't make any sense. but that's what the reality is. senator frist: you know, it's -- people ask me all the time do you wish you were in washington? i said no. look at dr. fauci of all people. what advice do you have? we have-- we are coming on the holidays here, and we'll wrap things up here. any advice to the public with respect to covid-19, just overall staying safe ourselves and our families over the holidays? dr. fauci: that's a great question. people need to hear that. i'm pleased to tell them. if you get vaccinated and your family is vaccinated, you can feel good about enjoying a typical thanksgiving, christmas with your family and close friends. we unfortunately still have the dynamics of infection in the community about 70,000 new cases today. when you go to indoor congregate
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settings, go the extra mile, be safe, wear a mask. but when you are with your family at home, goodness, enjoy it with your parents, your children, your grandparents. there is no reason not to do that. this will end, bill. we are not going to be going through this indefinitely. how quickly we get to the end depends on us. how well we vaccinate. how well we get boosted. and how well we do the kinds of things to protect ourselves. that's my message to the general public. senator frist: that ownership, the emphasis on each of us, each of us can control the destiny. and going to this pandemic to endemic where we started. i know we have policymakers listening to us. members of the public. we have outlined what about the
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holidays. and what to do. any final words of guidance for the policymakers or members of the public? dr. fauci: the policymakers i think they've got to continue to give support to what is very, very clear is the pathway out of that. we have had very good support from the administration, apart from a few attackers in the congress. the congress has been really, really good about this. so just keep supporting us and we'll get out of this together. we are in it together. and we'll get out of it together. senator frist: dr. fauci, thank you for your leadership throughout this difficult and challenging time. and your advice as we look ahead. thank you for johning us today. i turn it back over to anand for our panel discussion. dr. parekh: thank you, senator frist and dr. fauci for that conversation. thank you for your tremendous leadership during this pandemic.
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now i'm pleased to be joined by dr. leana wen and dr. jerome adams. dr. wen is also director of health care task force. dr. adams is a member of the opioid crisis task force. thanks so much for being with us today. dr. adams: great to be with us. dr. wen: thank you for having us. dr. parekh: we have heard from senator and doctor frist and dr. fauci that cover range of topic. i want to get your thoughts on several of them. jerome, maybe we can start with you with respect to where we are in the pandemic. as dr. fauci has noted, we have done well as a country. vaccinating americans, but we are still at a point right now where daily cases are quite high. there are about 1,000 preventible deaths occurring every day in the united states. what more do we need to do to suppress the virus and particularly your thoughts on how to reach better the 60
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million or so eligible but unvaccinated americans. what can we do better? dr. adams: thank you so much for having me today. i think first of all we need to remember it's not one tool. there is a toolbox that we now have that we need to do a better job of utilizing. vaccinations are the strongest, most important tool in that toolbox. but we need to continue to promote testing so that we can identify where the virus is. we need to continue to promote therapeutics. we have wonderful therapeutics out there, but not enough people are able to access them. again that looks back to tefght. you can't give someone therapy if you don't diagnose them promptly. continue to support appropriate ventlization.
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we know that's a strong, strong protective mechanism we haven't done enough to support. and we need to continue to help people understand that masking is important in certain environments that dr. fauci laid out. very quickly on vaccination, 60 million people eligible but not vaccinated. we need to understand first of all that this was not unexpected. we almost lost our measles eradication status in 2019. we have been seeing this occur over the past decade. so we need to understand that vaccine hesitancy has been growing in this country. we need to make sure we are using political distinctions to engage people versus attack people. i have been very concerned about how we have been using political distinction as a bludgeon to demonize people, to attack people and not as a way to engage people. you heard senator frist talk about how there are not enough conservatives involved in the
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conversation. i can tell you, i'm an independent but i am seen being part of a conservative administration. you are often told you are not welcome to this conversation if you are a conservative. we don't want to work with you. that's the message that lot of these unvaccinated people are getting. that pushes them away. it doesn't engage them. finally, we need to understand the root causes. it's not political affiliation. it's mistrust. it's lack of access to accurate information. if you are an african-american, mistrust that goes back decades back to tuskegee. it's still going on right now. if you are hispanic or la teeno, mistrust related to concerns about whether or not your immigration status is going to be at risk. if you live in parts of america that feel disconnected from the political leadership, that mistrust can occur for other reasons. keys are reaching local surrogate, local people who can help build that trust. doctors, pharmacists, local
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surrogates. the more we can empower them with the facts, the more we'll be able to transmit those facts to the people who are unvaccinated. number one, lack of health insurance. these are people who don't have someone they can go to and trust. we have to make sure we bridge that divide. dr. parekh: great. thank you. leana your take. as jerome put it it requires many different elements. therapeutics, masking, vaccinations critical. your thoughts specifically on the vaccination front. it does seem the last few weeks, months, the biden administration has slightly pivoted to persuasion from mandates to increase vaccination rates. particularly with respect to large employers, employees, health care workers, federal government employees and contractors. some of these regulations are caught up in the courts. but they may be having their intended impact already.
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can you talk a little bit about the strategy of vaccine mandates and emergency temporary standard as we try to increase vaccination rates, one part of the important tool that we have. dr. wen: of course. i'm glad to be joining you and jerome today for this important conversation. and definitely want to agree also with what dr. adams said in terms of importance of testing. and getting us through this period of the pandemic. we have to accept at some point we are not going to eradicate covid. we have to figure out a way to live with it. vaccines are a critical tool for us to do that. and along with these other tools, including masking and crowded indoor spaces will be an important message to get us to this point of moving from an existential emergency of covid to something we have to learn how to cope with. i thought that conversation with
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dr. fauci about how vaccines have really changed the landscape that last thanksgiving, last christmas, last new year's was very different from this one because of the add vend of vaccines. i do think that we are getting to this new phase where we have to figure out how we can come to terms with covid in our reality. but we can actually do the things we want to do and see our loved ones again. that's really different compared to last year because of these safe and effective vaccines. to your point about where we are with vaccinations. i really wish that we didn't have to be at a point where we have to talk about vaccine. i wish that we didn't have distrust as jerome was talking about. i wish we didn't have misinformation and disinformation to the point that people don't believe in the fact that we now have these safe and effective vaccines. i wish that the education and outreach that was done was sufficient and that we would have reached a point where we don't have these preventible
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deaths due to people remaining unvac sane nateed. unvaccinated. that's not where we are. i wrote a column for "the washington post" last week where two of the people interviewed from dr. scott gottlieb of the f.d.a. and doctor lawrence from georgetown who is a professor of global health law. the professor and i talked about how mandates, they could erode trust in public health. when you make people do something that they don't want to do. but at some point, they may also be essential for the public's health. how do you reconcile that? i think that this is the point that we are at now. we know that vaccine requirements including in the workplace do work. we have seen entities like tyson's foods reach over 96% of all their employees being vaccinated. we saw united airlines after
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instituting their vaccine requirements that they were able to get to the high 90's percentile. and thinks that having the vaccine requirement is recruiting advantage. it signals to potential employees they care about worker safety. there is a real reason why vaccine requirements are needed. but we also don't have to recognize the mill risk that that might entail. and do i worry just there are long-term effects to public health because of the fact that things should never have been politicized like mask answer vaccines are in these ideological crosshairs in the middle of culture wars. i worry about the long-term impact not just for this fight
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against covid but couldn't actually make us paradoxically and tragically even less prepared for the next pandemic. that important concept that dr. wen laid out. dr. adams: i want people to understand that from a public health standpoint mandates are effective at getting more people vaccinated from a public health messaging standpoint, this pandemic has been interesting because there is a social, a political element to it. that we haven't seen previously. mandates that don't come with a healthy dose of engagement and education to dr. wen's point can be harmful to us in the long run. i'd advice a lot of employers businesses and schools. here's what i say to them. i say to them you need to make sure you are surveying your constituents, your employees, and that you are framing not as a vaccine mandate but as a workplace safety mandate. what's interesting, i tweeted about this and talked about this frequently we need to make sure you are wearing a mask.
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again it's not so much about the vaccine itself which has been politicized in some quarters. it's about creating a safe workplace. you do have an obligation to create a safe workplace. someplaces have said we are going to vaccinate people. that's the only way we are going to do t other places have taken a more inclusive approach. it is a workplace safety mandate that is appropriate. we need to make sure we can reopen safely. at purdue we didn't pursue a mandate early on. the president at purdue university reached out to the students. and the faculty and said look, we want to stay open. we want you to have input. here's what we need to do.
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we need to mask. make sure we get our vaccination rates up. we actually have seen that we got over 90% vaccination on campus without a mandate. you can get there. the real key is engagement. if you fail at engagement, then the mandate. to dr. wen's point, may do more harm in the long run than good. even though they are an effective tool to get you over that last mile once you have done the engagement. dr. wen: if i could add to this point about mandates. part of my column was talking about how we need to turn down the temperature on vaccine mandates. in fact, the osha requirement that you were referencing, in essence it could actually be reframed as a testing and tasking mandate. that's what it is. it's saying that there is an obligation to keep the workplace safe. so we are requiring that everybody is tested on a regular basis and they have to wear a
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mask. but i think that the biden administration could say, but you can opt out if you are fully vaccinated. in a sense this is like saying, everybody has to go through when you go to the airport you have your i.d. checked, put your things through the security line, if you have t.s.a. precheck, don't you have to do these things. it makes your life easier if you have that thing. i think that we can reframe vaccination as that t.s.a. precheck or ez-pass. it's not that you are forced to be vaccinated, but rather that this is a path to opt out of that other more cumbersome process. and the end goal is not to get people vaccinated. that's not the end goal. the end goal is to stop the scourge and tragedy due to covid-19. i think we should focus on that as the goal that we can unite behind. dr. parekh: excellent points on framing. i want to talk about vaccinations, but for children. so this is sort of the other end of the spectrum for a moment. that's the other -- significant development that's ongoing now, 20 million children age 5 to 11 are eligible for vaccines. on a personal note yesterday i took my two daughters, age 10
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and 8 to get their first dose of covid. it's a momentous moment for us as they prepare to visit their grandparents in michigan over the holidays. talk a little bit about the importance of vaccinating kids, for kids, for parents, for families, as well as in the fight against this pandemic. dr. wen: i'm very happy for you and i'm also quite envious as well. i have two little ones, a 4-year-old and 1 1/2-year-old who are not yet eligible. dr. fauci laid out very well in the "q&a" earlier with senator frist how we have to really debunk this false narrative that somehow children are immune from covid-19. because it's just not true. we are talking about tense of thousands of young children who have been hospitalized. dozens if not more than 100 who have died in this age group on covid-19. covid has come out of nowhere in the last two years to become a leading cause of death, a top 10
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leading cause of death in children of this age group. yes, there is a societal impact of having 28 million kids of this 5 to 11 age group eligible to be vaccinated. the real benefit is going to be for families. there are so many families like yours, and that i know and that we treat clinical practice, whom have been putting their lives on hold. parents who are worried about going into in person work because they don't want to come back and infect their children. kids who have been going to school especially in areas of the country -- not requiring masking whose parents every night are praying that they don't get infected in schools. kids who have been pulled out of extra curricular activities and have not been able to do the sports that they love or have not been going to sleepovers with their friends for fear of covid. i mean, we can all agree, i think covid has been really hard on our children and getting the
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vaccines to them allows them to regain that sense of normalcy that i think is so important. and the knock on effects of potentially family members we haven't been able to visit. i mean, there are real tangible reasons for families to get their kids vaccinated. and i'm so glad that -- that we're now seeing a lot of parents toward the early adopters do this. and i hope that more familys will share their stories of these -- who are the early adopters who will share their stories of how safe the vaccines are and how they are allowing a return to prepandemic life. i think ultimately that's what's going to get us through this messageing difficulty of get getting many more parents to the wait and see group. i think that's what it's going to take for materially adopters to share their story. >> er got my 11-year-old daughter vaccinated last week. it's important that we reframe
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this discussion just as we need to reframe the discussion on vaccine mandates. it is tragic as dr. wen laid out. we have over 600 children who died from children hardly died anything, so that is a big number even though it doesn't seem like you do the average person. from a communication point of view, we have to understand that the majority of people in the united states are far more likely to know a child who is gotten covid and then died, that is just a fact. we are not going to scare people into saying you need to get the vaccine because a child could die.
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they prevent infection in the child's network and protect other children and adults. they prevent school out exam closings. my own daughter wanted to get vaccinated because she has seen her classmates have to be quarantined. many parents have seen that negative outcome. they preempt the need for masks and other mitigation. something all of us have seen. and we need to talk more about long covid, particularly in kids. is not all about dying. getting covid and not knowing where their child is going to have long-term negative impacts on cognition and this will help -- physically health. we need to emphasize these other benefits of being vaccinated, and not making it about your kid
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is going to die if they don't get vaccinated. that message is not resonating with what people are saying around us. >> that's very helpful. i want to shift gears. i was quite hardened in the conversation we heard, dr. fauci mentioned in terms of lessons learned in the pandemic was the need to argus on public health. and i have to ask you as public health officials, have we finally learned our lesson about the important role of having a robust public health infrastructure supporting public health in this country, whether is it is an existing that we have or an emergency like covid, what has it taught us about the importance of public health?
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>> i will jump in first then let dr. when take it home. we have not learned our lesson. we have had more people die this year from covid then died last year with more tools at our disposal. we tend to have an approach of putting out fires, and then we don't prepare, the fact is the u.s. did pretty well compared to the rest of the developed world. where we did poorly was that once you are infected we had far more people die from covid compared to europe. that's because we have such high rates of comorbidity, obesity, hypertension, smoking and other things that put you at higher risk for negative outcomes
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whenever there is a pandemic of any infection. and i'm worried that we haven't learned to love the lessons, and come to understand that we have to invest in public health, in chronic disease prevention, in the things that we know will create opportunities for people to be healthy like transportation and housing. all these things are the reason we saw these horrible outcomes from covid, it's not about as much the virus as our resiliency or lack thereof in this country. i don't want to be negative, but we have a real -- we are at an inflection point where we have to focus on the underlying rights in our foundation that really set us up and not just make it all about covid or all
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about some moment and really understand that it is truly all about the lack of attention to public health that has been taking place over decades and that i and my colleagues have been warning about for most of our careers. >> i really agree with you. all of us who are former health officials would agree that public health infrastructure has been decimated over the years. we as a country just do not pay attention to the focus on what happens at the end of the road. there should also be this focus on prevention and social determinants of health that many people will be sympathetic to. but that argus has not been there. one of my fears is that coming out of covid, emma's we are
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learning lessons, i don't want or public health to be equated with covid-19. i don't want public health to be equated with infection control. that is a component. but there are two things. there are these other issues we need to be inattentive to, chronic diseases, mental health, issues that were listed as crises before covid, and have gotten worse, they were unmet health needs that have not gone away, we need to double down on these issues and i want the focus to be on those, too. there is another aspect, because covid has been so politicized i think that equating public health for covid have long-lasting unintended effects that are pernicious and dangerous. we have seen across the country we have laws that are
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restricting public health authorities. if you are not allowing local public health officials to be issuing quarantines, what happens if they have multidrug-resistant tuberculosis and can no longer renting individuals. what happens if there is a new virus and now that will health department not issue a mask mandate to try to solve that threat. i do worry about public health being in the crosshairs of this partisan debate. that's another reason why i hope that we will not just see public health as being everything covid . we really need to step back and have this broader view on the life-changing impact broadly of public health, too. >> terrific comment.
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i see a few questions coming in on the audience. i want to make sure there is times we can get them answered. maybe we can work on the most important question the public, what advice do you have for the public as we get into the holidays and people start to travel and visit their family and what is your advice on how to stay safe? >> i would say that every family needs to assess their own risk and risk tolerance. a family in which everybody is generally vaccinated might take different types of risks than a family with him young kids or a family with elderly, immuno optimized family members.
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very different to last year, because we had protective vaccines, families will be able to say we will gather with loved ones indoors and have a normal thanksgiving or new year's again. i think that is a reasonable decision to be making. family members with more vulnerable family members or who also have a lower risk colorants may say we still want together outdoors, especially if there are number of unvaccinated little kids around. or, if we are going to be endorsed, we want everyone to be reducing the risk or a three to five day period beforehand, and then taking a test before the get together. that may sound like an abundance of caution, but that is what my family is doing and we get to the other with families over thanksgiving and are going to be indoors, we are asking everybody to reduce their overall risk for the three to five day period
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before or to take a rapid test the morning of. every family will have their own tolerance for managing their own risk at this point in the panama, there is no one size fits all answer, we are all making decisions that are best for ourselves and our families. there are steps we can take to get back to normal while still trying to keep safe. vaccinations, masking, testing, all of these are important tools as dr. adams said in our toolbox to help us get back to normal and do the things we most enjoy. >> i will just be quick. i want to reiterate something dr. fauci said which is we should be thankful and appreciative that we have so many more tools this year than what we had last year.
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and that will help us have a much more traditional holiday season this year. we need to balance that against the fact that the virus likes when people come together on that especially from all of us the country. the virus likes cold weather. we know that cases are leveling off and or increasing in certain parts of the country, we are going into a headwind and should be prepared for that. we know that we have challenges and we know that we have tools. know your risk, understand your circumstances, outdoors or indoors, ringing together people who have comorbidities or not, and then take measures to stay safe. the number one measure you can take us to measure everyone in your household is vaccinated, the number two measure is to make sure everyone who is asymptomatic does not have
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symptoms, because even if you are vaccinated and you have symptoms, you still could be spreading. maybe we can use some of these other tools like on testing kids -- home testing kits. my plan for the holiday season is are you vaccinated, and are you having symptoms, and c, if you are not major you have a test before you come into our environment. if you have mild allergy-like symptoms, if you have a fever or coughing or some sore throat you need to stay home. >> a couple of questions have come in. we will read them out, and feel free to answer whichever one. one is on personal safety. right now, is it safe for me to
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dine indoors? we talked a lot about framing and vaccines, but there is pushback. and a final question on public health, when we talked about the importance of investment and what legislators can do. public health, and framing vis-a-vis masking. >> i want to get dr. wens take on this. we have done panels like this quickly. she is seeing at pleading left, i am seeing it leaning right it is not about right or left. it is about public health we agree more than we disagree.
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i am going to say something controversial. i believe that masking is becoming less and less -- it's been a great public health practice, but you see more and more people in the country getting away from ask usage and mask mandates. it is important to emphasize that as a tool, but to understand the reality that we are in, and that means we have to rely on other tools that much more so. that is what it is more important if you want to get together with your family unmasked, but everybody is vaccinated. and we did not talk about getting boosted. 80 plus people who are eligible to get a booster because of waning immunity have not gotten a booster yet. that is important going into the holiday season to make sure you are using that tool. to make sure we are using those tools. i don't want to say that train has left the station on masking,
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the as it is still an important part especially in public settings across the nation. but i feel like we need to change our strategy to really august on other tools where we elect to have writer uptake -- greater uptake versus putting everything into the mask basket with the knowledge that people are moving away from masking. >> i will add to that first part of what you said as well. which is that i am also independent. this is one of the reasons i so appreciate working with -- we are not here to stake out a partisan position. we are here to work with everyone. part of our being in public health is knowing that public health depends on public trust. our job is to promote public health or everyone.
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so i appreciate the conversation and the pragmatic approach that we are taking to various policy conversations and to helping people navigate their own lives. on masks, one of the things i have been emphasizing our a while, and not everybody agrees. to the point dr. adams just made, we don't come from a country that has amassed morning culture. for many people, rightly or wrongly, this is no judgment on this, i have to point out that many people really do not want to be wearing masks. i've been saying that we really need to talk about vaccines. we see all these various tools in our toolbox. the other analogy i like to use is it is like adding liars, in the winter if it is gold you
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want to put on many lasers. the vaccine is this really excellent coat, the best protection if you will, against this "inclement weather," if you have the vaccine it would be advisable to remove some of these leaders. many people do not like masking. kids are getting vaccinated in schools and it would be reasonable to say that every child is vaccinated, then they no longer need a wet -- mask. adding that incentive of here is what you get if you are vaccinated, which i think for some people is usually offensive because they are saying isn't the vaccine saving your life? there are some people who are on the fence about getting vaccinated but there is that
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incentive up now you don't have to wear a mask, i think that will be very powerful. and that i think it comes back down to weighing personal risk, there are those with underlying medical conditions who may buy their own choice always be wearing a mask when traveling on trains or planes. or when going to the grocery store when i have on vaccinated young children it is not much of an imposition to be wearing a mask in hundred indoor spaces, but allowing people who are vaccinated the option to not wear a mask will be hugely help all -- helpful as we move forward and talk about the protective effect. >> we are almost out of time. we have about a minute flat. -- left. your forecast for 2022, it will be a big year in the global right -- fight and as we get
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more people vaccinated will be lookout for variance, of course. jerome, we will start with you, how does 2020 to look review with respect to covid? >> we have more tools than we have ever had before. we are now hearing about oral antivirals. we are seeing more and more people being vaccinated. cases are leveling off but it is still slowly going up. many people are continuing to get some degree of immunity and exposure to the virus. and we are going into an election year. the virus will continue to be politicized for other agendas. >> i say that because i want everyone watching to understand, we have the tools to contain this virus and learn to live with it and make it
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much less of an imposition on our lives, but it's on us. it's on us to use those tools and put the politics aside and make 2022 even brighter than 2021 has been as we've become more and more accustomed to this virus. >> and if there's anything we've learned in the pandemic is that the future is not pre ordained. the future is prech up -- very much up to us and what we're table to do. we have this science, pandemic science delivered on the vaccines, science is delivering on oral treatments as dr. adams has mentioned. i think we're getting to the point where we're able to live with the pandemic. we need one more thing, actually a couple more things. we need vaccines for younger children, speaking selfishly of younger children here and widespread testing because i would love to get to the point that other countries have gotten to where there's
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widespread free testing and testing becomes the norm before people enter crowded spaces where they get together with individuals. i do think that ending on a hopeful note that we'll get to a point ideally as soon as the spring where we're able to learn to live with the pandemic so it's not the existential crisis all the time in our lives. how it portends to her aspects of public health, i'm not sure, but i know it's going to take all of us to try to turn down the temperature and really focus on what unites us, which ultimately sudden be able for everybody to have a better and brighter future. >> and let me thank you for your leadership in particular, communicating to the american public the last 18 months about the pandemic. thanks for being with us today. i want to thank the audience for your participation and questions as well. as dr. fauci said

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