0 democracy. and the truth about the great shoplifting freak out of 2020. one state now proposing a bounty for parents who find banned books in school. when all in, starts right now. good evening from new york. i'm chris hayes. that's we are about to enter a new year. the third calendar year of the pandemic. take a look at this map. put out by the centers of disease control and prevention. it shows the level of community transmission of covid in america right now. laughing at sort of a joke. it's a pretty clear map. solid red in all 50 states. district of columbia and puerto rico experiencing cdc calls high transmission. we are getting new records. as daily case counts sore across the country to the highest amount we diversity. can see on this chart. line is practically going straight up. as we assess where we are right now. i think it's important to understand the fact, omicron variant is just much more transmissible than the previous variants. particularly, the early ones. just a different scale. professor of emerging infectious diseases at the london school of hygiene and tropical medicine estimates, what is called the are not of omicron, could be a size ten. which means every person infected with it infects on average another ten people. that is just so contagious. that is compared to an average of 2.5 people with the original strain. when covid first landed on our shores. and seven people with the delta variant. which itself was by far the most contagious variant that we've seen. to stop something that infectious, something within our not of ten, you would need essentially, 100% vaccination. it's like stamping out measles. basically everyone. to get to heard immunity. we don't have that. and so short of instituting extreme dramatic lockdowns. things like we had in march and april. this variant is going to spread like crazy. it is exactly what we are seeing. this moment is in some ways, one of the weirdest of the pandemic. during the two year mark and all of the sudden, dealing with the summer different beast in some ways. comes as the cdc just amended the quarantine guidelines. i think the first thing we should be doing about as we assess what's going on, what to do about. what is the goal here? if you are like me, maybe you are losing side avoid it is. i spoke to doctor anthony fauci last night on this program and about this very question. i thought he gave a striking an honest assessment. >> nothing is going to be 100%. this is one of those situations where you are dealing with a very difficult situation chris. which is you don't want the perfect to be the enemy of the good. the cdc feels and i don't disagree with them at all, that wearing a mask is ample protection. during that second half of a ten-day period. when you balance that against. the importance of trying to get people back. functioning in society. the alternative is something that no one wants. that is to shut down completely. we know that is not going to be palatable to the american public. that is something you want to be avoiding. so how do you get people back to function in society. not with a zero risk, but with a markedly diminished risk. >> today dr. rochelle walensky, the director of the cdc, echoed with doctor fauci told me. spoke about the cdc's no quarantine guidelines. how the intention was to strike a balance between minimizing risk and matt customizing compliance among a pandemic weary population. >> it really had a lot to do with what we thought people would be able to tolerate. we have seen relatively low rates of isolation. for all of this pandemic. some science has demonstrated less than a third of people are isolating when they need to. so we really want to make sure we have guidance. in this moment where we are going to have a lot of disease that could be adhered to. that people were willing to adhere to. >> let's step back for a second. just assess these developments and why we are at the point we are. the most important thing that has changed over the course of the pandemic. is that now, more than 200 million americans are fully vaccinated. nearly 66% of the eligible population. that is transformed the risk level and experience of the pandemic for the majority of those people. of course, there are still people, many people, millions of people who are immunocompromised and otherwise vulnerable due to age and medical condition. for the people who don't fall into that category. talking about 150 million people, maybe more. those people who are vaccinated, particularly those who are boosted. you know, the risk, the personal risk of being exposed to this. went from something that we hadn't really dealt with specifically like this before in our lifetimes. we haven't quite hadn't illness this infectious and this possible to cause serious illness. to something that does look more like the flu. now the flu of course can still be dangerous. kills tens of thousands of americans every year. but we don't re-enter lives around the flu. so that's closer billable risk that over 200 million americans are now dealing with. then when you add in the sheer exhaustion that people feel. i don't to tell you, this onshore. you are feeling this yourself. obviously the politics of the pandemic are still difficult than they were earlier in the pandemic. a very significant portion of the country thought the whole thing was bs in the beginning, as we already know. matthew walter put it in the atlantic earlier this month, outside the world inhabited by the professional classes and a handful of metropolitan areas, many americans are living their lives as though covid is over. maybe overstating the case a little bit. but yeah. an enormous swath of the country. vast majority of people don't care about. talk about, or certainly take active protections against. now, the hospital workers in those places sure do. compromise probably do. across huge swaths of the country, tens of millions of people are living their lives to the covid did not exist. it chunk of the country that does care. but is now vaccinated. people who care the most and also be boosted. wants to do things that were difficult for a long time. like get together with loved ones on the holidays. go to dinner, a movie, visit their friends. and understandably, people feel that those things come with unacceptable of risks now that they're vaccinated. so that leaves us where we are. the sort of politics. the broad sense of public opinion. institutional appetites across the nation. politics of normalcy. sort of willing things to be normal. people are over. i get it, i feel that way too. but then there's a virus. which just doesn't care. just a little piece of dna. floating around. and it's still very much there. and the most blunt tools we have to contain it. like non-pharmaceutical interventions. like lockdowns shutting things down. that all leads us to this kind of strange period where we are now. the modeling through phase. modeling through the omicron phase. we know is going to be disruptive. that transmits it is so high. you heard doctor fauci acknowledge that. and what i thought was striking language. saying it factored in the cdc's decision to shorten the recommended length of quarantine. there are going to be so many people testing positive for omicron, long periods of -- disrupt the functioning of our society. we've already seen flashes of that. industries are hit with outbreaks. in airlines canceling thousands of flights last few days. sports leagues canceling, postponing games. on monday, a record 96 nfl players tested positive in one day. broadway shows have been canceled. city emptied clinics in new york city have shut down because of staffing shortages. the big question is, so how do we avoid the worst disruptions, minimizing deaths? we know there is a key problem standing in the way of the. we have a huge pool of unvaccinated people. tens of millions of unvaccinated people. we have, through some combination of exhaustion, i think national human process of acclamation, got used to a truly devastating amount of death. i gotta. 12 to 1300 deaths per day, over the past two weeks. just churning in the background of our lives. i am not saying that to get anyone. there's truly only so much anyone can do to contemplating mass death. we seem to have reached a collectible decision that this levels tolerable. of course, not everyone agrees. some people who find intolerable have been very sharp in leveling criticism that the biden administration for in their view, tolerating it. i am sympathetic to a lot of their critiques. i think it's worth the english in between things the policymakers can and cannot control at this. more we know flat out. there is no tolerance for the kinds of broad lockdowns and non-pharmaceutical interventions we saw in the past. that is the kind of thing that you can expect. to suppress the virus. that is this contagious. probably the only thing. with their left with, is trying to manage what to do. if you can't do that. now, there are two places i think they fallen on the job. one is on boosters. they had a plan to boost every american. what happened, they allow themselves to get bullied by their own public health experts and advisory committees to muddy the waters on. and then this testing. the administration got a lot of criticism for jen psaki's off the cuff remarks. would you want to do, sentenced everyone in the country? the answer was yes. you should do that. here's the thing. look at the uk. that is a place that has instituted both of those policies. has one of the highest booster rates. in the entire. world has a lot of testing. . that has not stopped in omicron outbreak. in the, and that's with things look like. when you look at the country that has deployed boosters a rapid testing better than we did, they are still having insane outbreak. that is the inescapable reality of the contagious-ness of this new variant and the world in which we live. for the future suitable future. doctor peter hotez is the dean of the national school of medicine. co director of the texas children's hospital center for vaccine development. author of preventing the next pandemic. vaccine diplomacy. active commissioner of health of the state. great pleasure to have both of you returning to the program. doctor let me start with you. as somebody who is a public health official. who's had to do the stuff of public health. make policy decisions, under conditions of uncertainty. bouncing very different interests. how do you think about the way i laid out that framework. how you are thinking about this moment. in a state that is undergoing a very severe spike. >> that is true. new york state is undergoing a severe spike. we presume is in omicron. have 60% of our variants now, the omicron variant. 67,000 new cases is the number that we have from yesterday. we have that omicron pattern that you showed for the uk. that you described in south africa. and since i've been commissioner, we've done two things. one, the governor has declared orders a mask, or vaccine mandate. the other is we on december 24th, instituted for health workers a new period of isolation. following asymptomatic, positive tests. for covid. our tools are the same ones that you outlined. they are getting vaccinated. which is why the uk is not experiencing the kind of military lucky. we are also urging people to wear masks. i know people are tired. this is a creative and resilient virus. we have to match its creativity and resilience. with the tools that we have. so, we have really been pushing vaccination. and on top of that, really, rolling out testing. i hope that as we face the end of the year, another surge of this pandemic. that we don't get away from the things that made us so vulnerable in the first place. as a nation. to having one of the worst outbreaks of any wealthy nation. part of it has been the role that we played in the world. the fact we've been unable to push out the kind of global access to vaccines that the world needed. the other has been the huge low levels of inequality in our own society. which made so many people exposed to the virus in the first wave. and makes, in some ways, people kind of cynical. about the fact that government is claiming that the only thing they need to do is roll up their sleeves. like that photograph showed you people know that they need better working conditions, more housing. better wages all of those conversations need to take place as well. we in public health shouldn't shy away from them. you mentioned the global vaccine distribution. >> a lot of people of pulled to the pool of covid vaccine vaccination efforts and how those are behind. doctor hotez, you've been working on a vaccine to use technology. to have produced the technology with no intellectual property control. that can be distributed in manufactured across the world. a low cost vaccine that got approval. i believe for use in india. that you've been working on. can you tell us about that? how important that is? >> in our texas children senator vaccine development. part of the baylor college of medicine. which i coed with my science partner for the last 20 years. what we do, we developed low cost protein vaccines. that the big pharma companies won't make. because they are four diseases of poverty. ironically, about ten years ago, we adopted a coronavirus vaccine program. that, on top of our parasitic disease program. all we know how to do is make low-cost durable vaccines for use and research. that service well when we made the covid-19 vaccine. we licensed it with no patterns. no strings attached. help with development in india, indonesia, bangladesh, botswana. and he is the farthest along. with our partners. one of the strong vaccine producers in india. now haven't advanced purchase for 300 million doses for the indian government. they have 150 million doses ready to go. emergency use authorization. the ioc is, we just match the u.s. government commitment to global health equity for the vaccines. and level. you can go a pretty long way. we need to do this. here's why being sides the honest humanitarian drive. because it is the right thing to do. it is the fact that look, where delta came out of. came out of the unvaccinated population. omicron came out of an unvaccinated population on the -- as long as we refuse to vaccinate the southern hemisphere, we are going to have other variants. we would've been like if omicron had not been less severe and more severe, we would be having a very different discussion right now. the only way we are going to do that is to vaccinate the southern hemisphere. we think our vaccine is going to be the one that can really do this. especially from get some help. >> yeehaw. vaccinating the world is the only end goal here. the only way. it's a big world, but we got to do. doctor peter hotez, dr. mary bass, thank you so much. tonight, big news, federal jury returns five 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