Communications. Several staff here have worked really hard to pull this together. Emma colebrand among the foremost who have made this to believe. He was Travis Hopkins and clifford johnson, special thanks to them. And lastly, were just thrilled that we could bring this collection of great talent and Close Friends together for this conversation, and Susan Glasser has agreed to host for today. So susan, thank you so much. And over to you. Well, thank you so much, steve. And thank you not only to everyone who is joining us, but to this incredible allstar panel of experts that we have with us today. I cant think of a group that in my as a citizen and not just as an observeobserver, i hope y help provide us somedy fintive answers, recognizing were in a world where we couldnt have predicted what we would be talking about this week, even two weeks ago. No one will hold you to it, but i want to thank the panelists in advance for their expertise and insights today. Let me do a quick introduction of everybody, so our guests can understand what an allstar lineup this is. Just the order im seeing people on my zoom screen, i dont know if it looks different to you where youre sitting, but we are joined today by peggy hamberg, maybe raise you hand, peggy. Shes the former secretary of the National Academy of medicine. Of course, she was the head of the fda from 2009 to 2015. And before that, was the former commissioner of the new York City Department of health and mental hygiene. So she brings deep expertise on the ground and at the federal level to us today. Thank you so much, peggy, for joining us. Next, we have julie, who is right now the executive Vice President and chief patent officer for merck. Patient. That makes more sense. And before that, she was the director of the u. S. Centers for Disease Control and prevention, from 2002 to 2009. Shes recently described herself as a vaccine optimist. So im sure well have a conversation about what exactly that means. I for one am looking for optimism and a moment in time that hasnt been optimistic. So thank you, julie, for everything you bring to this conversation today. Steve morrison, youve already heard from him, senior Vice President and director of Global Health policy center. He has directed several different high level commissions, and brings a deep background and expertise to the question of what america had done to get ready for a Global Pandemic, and now, of course, what it is doing when it is experiencing one. And then we are also joined today by the ceo of the Chicago Community trust. Before that, she was a longtime ceo of care. Deep expertise in international Global Health. And spent 20 years working with the cdc on hiv aids, as well as with the bill and me linda gates foundation. So were delighted youre with us today, as well. Theres almost an overwhelming number of ways i could jump in and start this conversation. But i feel like its important to actually begin with a little bit level setting as far as where everyone in this distinguished group thinks we are today in terms of the pandemic. Because you hear a lot of numbers thrown around. You hear a lot of, you know, is it a spike, are we at the end of the first wave, the beginning of a second wave. You know, what is your best effort to describe the moment that were in as far as this. So im going to quickly ask each of the panelists to give me their best version of what we are experiencing right now. Just to frame that a little bit, right before this, i saw someone quoting a conversation they recently had with a friend of theirs saying im a little confused. America is reopening, what exactly is different now than it was two months ago when we were closing down . You know, the nurses response was simple and really quite chilling. She said nothing is different, really, except that we have a hospital bed to offer you when you become sick from all the reopenings. So i offer that in the spirit of really hoping to understand from each of you. Peggy, why dont you start us off on that. Thank you. Clearly, this is the most catastrophic Infectious Disease threat of our lifetime and the century. And i think we are still in the early days. You know, we have gotten through some very, very challenging times, places like new york state and my old stopping ground, new york city, are really showing dramatic declines in the burden of disease and the same is true in other hot spots across the country. But were seeing other places with numbers going up, and were seeing conditions that will clearly make it possible for infections to continue to spread, people continue to get sick, and all of the risks and concerns that we have been living will persist. You know, we dont know what the summer will look like in terms of, you know, all the discussions around, will there be seasonal waning, whatever. But this is a completely novel virus in terms of our human experience. You know, it is clear that there are many Vulnerable People that will continue to see infections. People talk arnbout will there a second wave . We arent out of a first wave yet. But were seeing such huge mobilization from the Scientific Community and we can take courage from that. We will be seeing, i think, some meaningful treatments, not magic bullets. But things that will make a difference in our management of this disease. And i hope jowly is right in her optimism about vaccines, and we may have a vaccine or multiple vaccines that are safe and effective and can make a difference in really preventing this ongoing pandemic and protecting not just this country, but the world. Julie, do you agree were still in the first wave, as it were . I see this exactly the way peggy described. You have to step back and realize that with rare exception, at least 90 of people are still vulnerable to this virus. So what were really doing is conducting a very large social experiment. We have proven that social distancing and lockdown actually does slow spread, and protects our Health Care Surge capability. And now with various degrees of relief from that lockdown, were on erving what happens. And i think were experimenting with the calibration. How much openness can we tolerate before we see a very rapid return to the upflow of the curb that we saw when the virus first arrived . And we have some sobering news about that. I think in places that are demonstrating more flexibility, less social distancing and things, were seeing more cases. In some cases that may have some of the requirements, were seeing many citizens continue to wear masks and avoid crowds. So essentially the top down decisions about what needs to happen, havent necessarily changed the way individual people are behaving. So theres a lot of vary buiiab and uncertainty about where this is going to go. I am not optimistic about the consequences of reducing social distancing. I think we need to be very cautious before we fully return to any kind of sort of business as usual approach. And i will just qualify the vaccine optimism a bit, cautiously optimistic is the best way to characterize it. I say that because there are 130 vaccines in progress. The collaboration is enormous. The investment is enormous. But in addition, we know from animal coronaviruses that these vaccines of a family are something that you can create successful vaccines to. So i think the science is on our side, but that doesnt say anything about the speed, safety, dur build aability and other criteria that have to come into play before we can have something to count on before we have the population immunity against this pandemic. Theres a distinction between your optimism, tempered as it, is on the vaccine versus the situation with the virus as it is right now without a vaccine. Let me just quickly ask you before we go to steve, you hear a lot of things thrown around in terms of timetables and the like when it comes to vaccines. Help us understand what you think is the way we should hear those things. We hear the president of the United States saying its just going to be october now, conveniently before the election, is the latest date that hes been throwing around. Is there any possibility of that . I think its important to understand that there are some early potential candidates that are moving very quickly into the more advanced phases of the clinical trials. If were extremely fortunate, those vaccine also have the desired properties to make them good vaccines for widespread use. But its not just enough to get an antibody response. We need to have an antibody response thats protective. We need to have one thats broad enough so that minor variations in the virus are not going to attenuate the effectiveness of the vaccine. We need one thats durable, so we dont have to get it periodically. Ideally we should have a vaccine that only requires one dose, just from a logistics perspective, when youre thinking about global immunization. But we need a vaccine thats safe enough to be used in broad populations of people, Young Children potentially infants, elderly people, we have to be very mindful that this is likely to end up in a situation where we have more than one vaccine, and that well be learning how to use them in the most effective way in the target populations where they make sense. All of that is a tall order. Although we can compress the time line by doing things in parallel and not in theory, we cant short cut safety. I think thats one of the things that Everyone Needs to be paying attention to, and im relieved in admiring colleagues that are on the front lines of this right now, because we are finding ways to work with the regulatory agencies and make sure the safety data is accessed. But at the same time, doing a lot of other things in parallel to shorten what is normally a fairly prolonged timeline. Having said all that, just experience from merck, bringing the ebola virus vaccine across the finish line, which we really went into clinical studies of it in phase three in 2014 and took until 2019 to get the vaccine fully licensed. We were doing everything we could to move that vaccine through the process quickly. But it takes time. You cant always predict what the manufacturing productivity is going to be like or how the vaccine is going to behave in reallife circumstances. So a little scientific humility is also an important component of the communication here. So somewhere between five months and five years. And well hope its closer to five months. Ev steve, i want to get your sort of sense of where you would say our Baseline Assessment is right now, and then we can go bigger. A couple of quick points. We crossed the 2 million mark of cases in america out of a global total of 7. 3, and adding about 20,000 per day. Weve lost 112,000 people to this disease, out of 410,000 globally. Were losing 800 to 1,000 a day. And 14 states today that have reopened that are seeing accelerated infection rates that are at the highest in the sevenday cycle, the highest they have experienced. So its a dangerous situation, and obviously it raises the question did they was the reopening premature, at least in those states and where does it go and what actions need to be taken . Oregon has postponed the next phase of reopening, but it begs the question of, where do you go from here . Were seeing in this rebound period quite aggressive spread in rural areas. Rural areas that are very poorly prepared for this. The second point is the complexity of this disease. Were discovering that it attacks the vascular system, kidney, weve seen in children this frightening syndrome, kawasaki syndrome. So were coming to terms with the dangerous and complex nature of this. Its posing a huge burden on those that are poor and people of color and those marginalized. Its striking them with an impact that is far more ferocious than what the rest of the population is experiencing. These are people who live in poverty. People who are living close to one another. Who are in jobs that have special exposure of risk, and people with underlying conditions. On the vaccine, i would just say that were seeing exceptional collaboration across governments, industry, foundations, international bodies, which is very encouraging. When we look at the moment where we need to manufacture and distribute between 5 and 7 billion people, that is enormous undertaking and very expensive. The ranges are between 25 and 65 billion in order to meet that requirement. Thats a daunting challenge. Thank you. Thank you so much for your patience. You know, has anyone said anything that strikes you as wildly off at this point, or are you also a believer that were at a risky moment as far as the first wave goes . Yeah, no, i would totally agree with everything everybody has said. You know, i think we are one of the things that is so scary about this is that we both, you know, dont have the tools and dont have anything historically really that we can look to, to give us a road map. I think the newness of this, the fact that we are still evolving in our knowledge and that we have such limited tools makes this very difficult and dangerous times. Added to that is the fact that i think in many ways we are weaker as a nation in our ability to come together around this. You know, the fact that we are seeing states do very Different Things that may or may not go along with what is the best Public Health guidance at a time when we really need to have a much more i think harmonized response is very i think very scary. I also think that, you know, the challenge some of the challenges that steve laid out in terms of populations that are impacting, one of the things that is so different about this is that this is the first time weve had a Public Health crisis that also caused an economic crisis at the same time. And if we think about the ramifications of what the economic crisis has done, who its most impacted, we really have this kind of double jeopardy that i think were dealing with. So it is difficult and challenging waters to wade through when we just dont have any real road map that gives us answers. You framed up so many of the issues that we really need to talk about further today. You know, just to name a few of them, this sort of very unequal impact in outcome that has been an aspect oh f this. Of course, which may be accelerated or emphasized even more with the combination of the economic as well as the Public Health aspect of it. The other thing i think that you flagged thats very hard to talk about in a Public Health setting, but clearly we need to, in the Political Polarization and the radically different approaches, you know, you might have had that no matter what. But i was making a list before this conversation of the number of different manifestations on concrete actions being taken as an individual and at the government level. I wanted to ask everyone about that. You know, its mask wearing is one example, where it is more politicized here in the United States than perhaps anywhere else. And you can literally overlay peoples political affiliations with whether they are taking this Public Health advice. Number two, the authority of the very people who are on this panel has been sort of turned into a partisan issue in a way that is quite striking. Actually, there was a very interesting number that i saw in a new piece in the atlantic that suggested that at the beginning of this crisis, both democrats and republicans, you know, had similarly high view of authority and that their willingness to listen to Public Health experts, thats changed pretty significantly after months of it being under assault. And now you have a far, far higher number of republicans who no longer believe in the credibility or will take the advice of Public Health professionals. And number three, just in terms of ways in which were seeing this political divisions in our country exacerbating and complicating the ability to have a national response, not only do we have states taking different approaches to reopening, but you have very different views, depending on peoples political beliefs about what the correct next steps are. So helene, ill ask you and then go back to the others. Sit too late to correct for that . Is there any way that we can stop the polarization from further hindering a disease thats already claimed 115,000 american lives . Or do we have to accept that from a Public Health stand point as a reality of this coronavirus at this point . You know, i think the horse is out of the barn, so to speak, to a certain exextent. It has become taken out of the Public Health realm in many ways, in the realm of knowledge and science, and i think has been politicized. That said, i think there are continue to be voices that try very hard to get people refocused on this as a Public Health issue. And i think all of us in our own way, and why im glad were having this discussion, need to keep thinking about whats the Public Health imperative. How do we get people thinking about lives being lost and all the Collateral Damage that goes along with it . You know, i think it was julie who said that were living through a natural experiment. Perhaps that will also open up peoples eyes. You hate to think we have to see more deaths, but when you start seeing spikes and increases in places that opened up early, you know, and we know that the all of the social distancing and all the rest of the Public Health guidance really did make a difference, perhaps that will start opening peoples eyes and take this out of the political realm and put it back into the Public Health realm where it blo belongs. Julie referred to lets have some scientific humility here. Do you think, peggy, helene is right that there are any ways to address this poet llarization. Its an assault on the credibility of science and questioning of its va