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Communities and issues with politicizing the cdc. This is 30 minutes. They sent guidance about an vaccine amb pfizer said it was on track for government review for early october in madrona and astrazeneca talked about vaccines inre october. Against the backdrop and what astrazeneca, what your best estimate for a safe vaccine being available. One thing i learned im into data and science. When does the data and science exist. Based on enrollment right now going on with pfizer in madrona that is conceptual that they will have enough data to presented to the fda for evaluation somewhere before the end of october and the end of november. The reason i cannot be more specific because these trials are event driven trials in the really 100 dependent on how much covid occurs in the volunteer population. If its a lot of the individuals or just the total number of events than the potential for them to have enough events if the vaccine will be in october timeframe and if the vaccine is 50 and might be in the late november timeframe and if there are fewer events in a very good vaccine and might be in late november, december timeframe. I think we can all say somewhere between the end of october and the end of the year it is probable one or more will be presented to the fda law review for an emergency authorization or potentialen for approval. By that timeline what would be the time range when we would start seeing vaccinations being deployed. Because projects warp speed as i said not taking shortcuts on safety or scientific integrity, as we say here today, those vaccines from a moderna in pfizer and astrazeneca are being made for use to be distributed if the fda can determine that their safe. Normally what would happen you have to wait until reviews the data and they would to the vaccine is safe in the Pharmaceutical Company will begin to figure how to manufacture and it would have a sixmonth twoyear log. This vaccine is going to be available, it will either be a bunch of souvenirs if the vaccine does not show to be safe for applications but to save that time and its really important time particular for those of us who have comorbidities over the age of 65, the sooner we can have a preventive vaccine for covid, will transmit to saving human lives. There was an acceleration to make sure there is not an administrative delay because the dynamic of how we develop vaccines. That was really remarkable operation warp speed. Not that were taken a safety shortcut like i said with astrazeneca trial withhold and not that were taken scientific in principle short steps but we are taken a financial one. When we ask when do we think the vaccine will be available broadly to the American Public, if everything goes really well that will be sometime in the first or Second Quarter of 2021 but the high risk prioritized individuals is conceptual that vaccine can be available in late this year or early next year. What is so important about that and people get vaccinated, we have this Information Campaign long before covid concerns. There havern been surveys with actual covid and having a tendency to get one in the politics of the election cycle that is operation warp speed and the president has said the vaccine can be available before election day and some say the cdc is subject to political pressures and with all of these headwinds, that is being polite to call them headwinds. How are you convinced that a skeptical vaccine when it comes out is safe. Its really important and one of the goals for the cdc director is to move away from what we call a Vaccine Hesitancy to a culture and our nation in wisconsin, when we find lesson 50 in the politics, i tell you in the last decade 360,000 people diedth of flu and we actually have a vaccine, how do we begin to get the American Public to embrace the vaccine. Dont leave one of the most important contributions of science in modern medicine. So many people still leave the on the shelf for themselves and their family and their communities. We are trying to build the advocacy but its a long journey because lets take nonCovid Vaccines. The reason they are hesitant to vaccinate because they dont want to make a mistake for the children. I had six children and it will take time for the Healthcare Professionals to sit down and have a dialogue about this. Maybe several times and a lot of times doctors will ask you to want to get a vaccine and thats the end of theat story. And theres a Nurse Practitioner to reengage in that discussion, some are misinformed and when someone is misinformed you cannot say youre misinformed you dont know what youre talkingar about, you gotta engae in the dialogue and get them to understand so they can come to their own conclusion that there misinformed. This has a a serious issue and m very concerned about a particularly when the Covid Vaccine and not something that should bee politicized. Did you say please dont politicize this, please dont use this in your speeches or the other candidates for that matter, you have to have everybody around and this cannot be an issue of politics. My comments to the president i keep to myself but i will say publicly other just said, this cannot be politicized. Once you instill fear in someone, it is very hard to remove, so i had a challenge that is the disparity of vaccination, lets take the flu vaccine for example in only 28 of spanish latino, im very glad we got it up in the high 30s but thats only the high 30s, andy the African American Community Save 41 and 48 . I dont need to reinforce hesitancy. On either side, not taking sides, either side is politicizing this and is working against the gold in the american cultureof before they vaccinate, we have some schools in this country where less than 30 of kids are vaccinated. Thats my resolve the Measles Outbreak in this is really important in the. Added concern when people do view that this vaccine is being rushed and it may impact safety and im trying to tell you from the cdc point of view the only thing its going to dictate this process as dataoi and science and we would like to have us be able to continue do that and the companies have also made a recent commitment that they are in line with the whole concept and we should celebrate when we have a successful application covid virus and i didnt think we had room for couple years i thought my cdc career was going to be needy in a war against covid and now i see it if we have an application for a vaccine of two or three and now or next summer we can get this behind us. Those are important words, take your science and medicine, before we get to next summer we gotta get their fall and winter and i want to ask you about the seasonal flu and how that collides with covid19. What is your assessment given the pandemic. I made a couple new cycles back in april and i thought the october, november, december would be the worst Public Health that this nation has had. In reality, the flu and covid, we almost in a bad flu season those hospitals that are overwhelmed in the bag covid overwhelms hospitals there in chicago and detroit in los angeles and down in new orleans. But its very interesting what awe are seeing, flu transmits l yearround, we actually peek in the late fall winter thats what we call flu season but we are transmitted in this country all yearround and we have the lowest transmission of the flu. Why w is that, lots of flu transmission, masks, social distancing, handwashing, being smart about crowds. The same things in our colleagues in south and australia in the mildest flu season theyve ever seen. I do believe that the American Public does five things for me, where mask when they cannot social distance, social distance vigilant about handwashing, be smart about crowds and indoors worsen outdoors, do that more than outdoor, stay away from crowds, and the last thing i do is get vaccinated against the flu, we do those five things and theres a good chance. What i feel through individuals who have not had a vaccine for flu before is one of the things of flu vaccine does well, it may not prevent infection but it does modify. If you and i get our flu vaccine so if and when we do get there we dont end up in the hospital with a 72yearold woman with covid needs with the doctors and nurses are not overwhelmed and were doing our part. Let me tell you story i was talking to somebody the other day who just flew across the country and had to stop over in atlanta and walk through the airport in atlanta and told me it was crowded and there were people not Wearing Masks or people wearing their masks over the mouth but not over their noses and not properly and he was very concerned about that. How concerned should we be with the covid fatigue or just asserting freedom or whatever you want to call it and make those five things, even after all the assistance you and others have had on this point, harder to do as we go into the seasonal flu season. I think you hit a big issue and i was in hartsfield a couple weeks ago and i only observed a few people without masks but there are plenty of places in this country where people still have notil fully embraced particularly the younger between 18 25 have not embraced the importance of what i just told you. Again we can only continue to try to appeal and i always quote the drunk kennedy quote dont ask what your country can do for you ask what your countr you car your country. And to become a warrior in the pandemic through the five things we will bring this outbreak to an end. Let me ask you about another aspect which is also very important, we talk about health mpdisparity a lot and you mentor minority population. What is the cdc done to ensure the supply of vaccines when it comes sufficient in the vaccines and the promotion of those their minority communities have beenh so hardhit will get the attention it deserves. The biggest thing were working very hardd on now is to prepare for the distribution. You heard the National Academy came out with some of the recommendation and we heard the Advisory Committee and we will ultimately make all the data in the come out and set prioritization of where they recommend the vaccine. Its gotta be in the process of putting that together. That vaccine once is prioritize has to be distributed and weve gone out to the initial before the states of one major city and we work on the micro Distribution Plan and by the end of this month we will have put those plans to be developed and all the jurisdictions acrosss te country. Ultimately we gotta get prepared for that distribution. What was that distribution, was it recognizing the disparity of this illness, prioritize the distribution among those communitiess hardest hit. I think that is going to be obviously one of the key priorities and ultimately that recommendation is going to come from theat Advisory Committee. I think theres two major issues right now, the group thats at risk for infection, the occupation of the group that t is at risk if they do get infected, thats where we see the elderly in the minority populations, not that theyre at risk for infection but a greater risk if they do get infected because of comorbidities of the outcome. This is why im not excited and i like to fight back about anybody that says things to develop fear in individuals particularly the minority populations. To take the back seat. Because then you have a process where we have a vaccine and we wanted to distribute groups that were outback outcomes but if you hiselected the decision by one group or another will take the vaccine. Programs that are working in partnership with the flu vaccine in the Africanamerican Community and hispanic communities to increase uptake, i mentioned its still not over 50 those communities and we made a lot of progress in the last year but we have a long way to go, were still under 50 . Its really important to both confidence and everyone particularly in the African Americans and spanis hispanic ad latino, native American Population to embrace the vaccine when it comes on. Clearly theres going to be a prioritization and that will either be by a doctor or highrisk individual or are you someone at high risk for the outcome. I think those will be the two priorities and depending on how much vaccines are originally available it will be prioritiz prioritized. It probably will not be until after the first of the year when we have enough vaccines and broader availability in the broader American Public. The first 50 million doses are gonna be prioritized for those two populations baseded on outce are based on risk of infection. Do you know rightly or wrongly the cdc guidelines that a been expressed and are very controversial. And we say the cdc is advocating fewer tests are actually better, right, wrong, what to say to w this . Absolutely not wrong, testing is a part of our strategy and what the cdc was saying although unfortunate was not recorded correctly is we were saying we want to play emphasis on testing individuals that have symptomatic illness or individuals that have significant exposure so they can be asymptomatic or vulnerable population like Nursing Homes could be asymptomatic or Critical Care or Critical Infrastructure workers or healthcare workers and First Responders in which can bes, asymptomatic and lastly we said for individuals who may be asymptomatic but prioritized by the doctor of Public Health. What we were trying to do is get testing to drive action for specific publichealth objective and bring it back. We stopped third drive and get tested and only finding out about the results five or 67 days later, that is not actual testing. It was unfortunate then one of the network said we recommend against testing. We did not. The first says entrance and says you may not need to be tested for asymptomatic in the second we want to engage your doctor publichealth person. Were trying to get that focus and im glad you broughth it u, testing is a critical part of our testing strategy and asymptomatic is a a part of our publichealth strategy. We just want to do it in a way that is actionable. Let me ask you this followup it is so important. When the guidance. No there is not just noise in the media but there is noise in the political atmosphere and Governor Andrew Cuomo said we are not going to follow the cdc guidance, my considerate political propaganda. His words so hardly the public is so angry, what do you need to do and what are you doing at the cdc to inspire confidence and clarify this and make people understand it that your independent pushing back against politics and trying to follow science and keepo people health. The first thing we did was literally minutes after cnn reported incorrectly we issue the cdc statement on guidance which i clearly said everything i just told you. Unfortunately that did not seem to make the news where we said testing was meant to drive action to publichealthesct objectives. We said everyone that needs a test will get in everyone that wants one may not necessarily need it and its to engage in publichealth community. I just read you governor cuomos words. I told my good friend howard the state Health Department and explaining everything to him but unfortunately you hit another head a lot of people have chosen to try to politicize. I just tell you that the cdc is a datadriven sciencebased eservice organization. I am a research publichealth person, im not a politician and my friend at the fda is a great oncologist, not a politician and its disappointing for those of us that decided to serve and people want to assume our decisionmaking processes somehow i can only tell people that i know for myself that is not influenced by politics. That saying that is equity change people that are excited that one way or the other, there are people from both sides of the political spectrum that want to try to suggest organizations are making a a politically not only lead 23000 dedicated men and women to publichealth in this nation and will use our best effort to do the work that we can to put science and data intoto action and try to improve the publichealth in this nation and i cannot wait until were out of the political season because maybe then we can get back but i can only tell you politics is not entered in the publichealth decision that we made, there are many people that try to suggest. Take an example you talk about vaccines, my team and i wrote a letter to one of the states to be prepared to deliver the vaccine. All the sudden because we wrote that knowing that we might have a vaccine by november please get ready to be prepared. People assume that wasov a political, no were asking states to get prepared. If you want to do a critical problem for credibility for cdc it would be to have 50 million doses of vaccines and we dont know how to deliver. That would be something thats overdoing but immediately some people want to suggest there were asking states to be prepared thats a political statement. But all the words that i say will not convince people and we will continue to stay focused and in closing this i constantly read every morning a quote over my desk which is from Teddy Roosevelt saying the man or woman in the arena. Let me try to understand what that means. We try to come up short but at the end of the day we either know the triumph of the achievement that we failed greatly. Thats the road were on and we will continue to do what we think is in the best interest of the American Public to improve the conditions and more importantly you will ask a question or two trying to keep the agency to make sure one of the casualties of covid is in our program on the work of opioids. Its not a programmer trying to improve, 700 women died last year, we should not have internal mortality like that in the quick happening to suicide a Mental Health. We are really important programs that cannot go on autopilot. I try to keep my men and women at the cdc enthusiastic about this. I think its the one thing that i can take the criticism but it hurts me when i see the minimum and losing lives and read stuff that is not true that they may not be quick to understand as well and it modulates their enthusiasm. And therefore they began the less enthusiastic. Its really one of i hope when reporters write stuff and they realize they can motivate the American Public or they can demotivate. I just want to say for the wholesomeness of the conversation. That advice should not even primarily go to journalistsen ad reporters although it certainly belongs there because theres a lot that can be done. But also to political leaders and on the public stage you also politicize and take a first step to that. We should be listening to you the doctors and you should be told you the science, medicine, always must come first. This is about safety not opini opinion. He raised the opioid issue and i want to get to that before time runs out. While covid is an urgent crisis, there are so many other crisis for which were dealing with an eye know youre dealing with and you feel passionate w about. Covid is crowded out the focus on the opiate crisis into anyways. Wall street journal just collected data across the country and found counties nationwide are experiencing a rise in opioid death for more than 70 deaths last year which was a record. How in your view has covid compote complicated the crisis to combat it. I think at theie very begin beginning, it was a lack of surgical approach and how we limited medical care. Clearly there was an attempt to do not complicated surgeries to put people in intensive care units without we would run out of intensive care units. That did not mean shut down Mental Health services. Down to daily opioid treatment programs. There was a nonsurgical approach to this as you know. There was a huge loss in access i think to quality medical care. Either you believe if you have a drug use disorder that your interactions with the medi p and to shut that off was unfortunate. With a 17 or 18 percent increase we had an increase in suicide we are trying to get those Services Back up and running the medical community at large. And those that us adults with anxiety and depressive disorder and 26 percent there is a huge psychological consequence. I almost lost one of my six sons to covid who almost died from contaminated cocaine with sentinel. Now hes in his fifth year off recovery. Its a struggle. I a new drug use disorder i was a physician in baltimore and until it came into my own family i had no concept of what drug use disorder did. As a chronic medical condition we need to treated asen such. And another situation that requires medical intervention. And those to get back into treatment and those with chronic pain disorder couldnt get treatment and with selfmedicating with the drug overdoses. And when we look back at the casualties that occurred doctors always say do no harm. I personally believe there was harm. And there was harm in the medical care. And to make sure we prioritize medical care and education and edk12. To do it safe and smart. But we did lose grounds on opioid and now we have to make it up. Thank you for all you do and your comments that that should drive everything we are doing and all the best with your battle against covid and for you trying to do no harm. Thank you. I cover the house and senate whats going on the house and senate floor and the legislation on the daily and weekly and monthly basis. Congress is coming back into session and with us district and Circuit Court that President Trump has nominated. So those that have put together their own proposal includes money to promote jobs and going back to school and Small Businesses to the paycheck protection program. That has a targeted amount of money. So right now Mitch Mcconnell once a more targeted bill he will introduce it this weekend. So is there any chance it creates its own or is that not a priority for the senate . And also increase funding. That legislation he would think that type of legislation that had bipartisan support according to Mitch Mcconnell and theres no plans to bring that legislation up at this time. 22 days until the government. The Government Shutdown is a major priority neither side says they do not want to Government Shutdown. The government is currently funded through september 30th at midnight they have to pass legislation to make sure that funding does not run out and a Government Shutdown would occur. Secretary the nguyen as well as Speaker Pelosi said they both reached an agreement to make sure Government Shutdown would not occur and potentially government funding ending september 30th but the devil is in the details and we dont know any of them yet. Its a major push with little more than 20 days left before the government could shut down but that continuing resolution or the shortterm spending bill and hopefully the president with the shutdown. Any of those. The house returns next week for the bills they plan to take up. That related to the covid19 pandemic and the House Democratic leaders are fighting to condemn that type of language. Also to decriminalize marijuana and the legislation that help Democratic Leaders to bring about diversity in schools in light of the recent protests. In the house. This is 90 minutes

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