Ron Klain – What This Pandemic Has Taught Us

Andrew Schwartz: You're listening to The COVID-19 Update, a podcast from the CSIS Global Health Policy Center focused on the science and policy implications of the outbreak. I'm Andrew Schwartz of the Center for Strategic and International Studies and I'm joined by my colleague, Steve Morrison, to discuss the latest on COVID-19.

Steve Morrison: Today we're delighted to be able to have Ron Klain join us on this podcast. Ron's former chief of staff to Vice President Biden and before that, Vice President Gore, served as the Ebola czar when we first got to know one another quite well in 2014, 15. He's a columnist in Washington Post and frequent commentator on the cable networks and is a senior figure in the Biden campaign. Ron, thank you so much for joining us today.

Ron Klain: Thanks for having me. Always a pleasure to catch up with you on these issues.

Steve Morrison: So this is billed as a particularly horrible week. We've seen what's happened in New Jersey and New York City. People are watching carefully what's happening in New Orleans, Detroit, and many other urban centers. And we've gone through a number of really big mistakes, so around testing, around PPEs and ventilators and reagents. And we're seeing a sort of dangerous politicization, partisanship here and an anti-science, anti-public health mood that's jumping forward here. It's really a particularly disturbing and difficult period right now. And we know that pandemics change history, they change norms, they change institutions, they change societies and demographics clearly. I'd like you to look forward for a moment, start the conversation by asking you, what do you think the conclusions are going to be from those who are looking back in five or 10 years at this moment in time, what do you think the main conclusions are likely to be?

Ron Klain: Well look, I think people will look back on this and they will see a couple things. First of all, they're going to wonder why all the warnings that people like you, Steve, and your colleagues at CSIS and other blue ribbon commissions issued over the years, why they were ignored, why all these things that were so clear as almost inevitable to happen, why they weren't paid attention to. And so when people say, "No one saw this coming," I just have to always push back against that because many bipartisan groups, many think tank groups, many groups of elected officials have been saying for years, something like this was going to happen. And that's I think the first thing that people will shake their heads at, wonder why all that was ignored. And then I think the second thing will be, well, once it started, why didn't we act more quickly?

Ron Klain: We certainly knew in December, in early January that we were going to face an outbreak, an epidemic of coronavirus in this country. I don't think we knew quite how bad it would be. There was still the data was uncertain, but we knew this was coming. And so why didn't we do more, more quickly to get ready, to prepare our healthcare facilities, to get the testing in place, to get the gear for our healthcare workers, to get the equipment we needed to treat patients? We had time to do this and we didn't do it. And that's a problem. And that's again, I think there's going to have to be a reckoning on that. I also think though, some things are going to change going forward. We will learn some lessons out of this. I think if you look at how different countries have reacted to coronavirus, those countries that had an experience with SARS were the ones to put the social distancing restrictions on most quickly and most extensively.

Ron Klain: They had lived something like this before and they knew what a difference going quickly and strong on social distancing could make. So I think it's important as we think about coronavirus to realize that this is going to be with us for a long time. We're going to probably see this current wave of cases fade, but then another one come back and hopefully when that comes back, even before we get to what happens five, 10 years down the road, we're talking about six, eight, nine months down the road. Hopefully we will react more quickly and more decisively when this threat re-emerges.

Steve Morrison: Ron, have you given much thought to what the priorities are likely to be on the other side of this pandemic in terms of restructuring our approaches in government and internationally as well? If anything, this pandemic should be the force that finally breaks the code on this cycle of crisis and complacency that we've been stuck with for decades now and there's going to be a lot of soul searching, but I do think that we're going to be a different government on the other side of this crisis. How would you spell out what the reform agenda is going to look like?

Ron Klain: Well, I certainly hope so that we will be different in the way we handle this going forward. I think there are a couple of things. First of all, I think the benefits of investing in surveillance and investing in detection are clearer than ever. So I think some of the things we saw in recent years with cuts in the PREDICT program, cuts in CDC, I think those things hopefully will never happen again. And if anything, we'll invest more robustly in those kinds of programs so that we can get as much advanced warning about what's coming and where it's coming as possible. Secondly, I hope this is a wake-up call that our healthcare security in the United States is inexorably interconnected with the health security of all parts of the world. Look, we can have a big debate about what kinds of travel restrictions president Trump imposed and when he imposed them and how it compares to other countries and was it enough and was it too late and all these things, but the reality is that no country can wall itself off in this interconnected world from the health threats of other countries.

Ron Klain: By the time we see these threats coming, we've got just enormous amount of travel and trade that's occurred and so on and so forth. So the only way for us to all be safe is to have an early detection system that's global in nature and a strong response system that's prompt and global in nature. And those two things I hope are the lingering takeaways from this. We in the United States, we have the benefit is always of two oceans between most of the other continents of the world and a large country and all these things and none of that, none of that protected us from the coronavirus.

Ron Klain: We already have the most number of cases in the world. We're probably going to have the most number of deaths in the world. Maybe other countries will surpass that eventually, but we certainly are getting slammed by this, notwithstanding the benefits of distance and some isolation here as a continent apart from Asia and apart from Europe, and that's not enough to protect us. What's only going to protect us is being able to get the information more quickly and get our preparations up more robustly when the warning signs go off in the future.

Steve Morrison: I do think we're going to have to restore the public trust and confidence and we're going to have to be very busy at protecting our jewels like CDC and others, and putting in place some structures in government that are authoritative and competent and very quick moving or I mean we've... This has just been a period of gross disarray and incoherence in the response. I want to ask my cohost, Andrew Schwartz, to jump in here.

Andrew Schwartz: Thank you, Steve. Ron, along those lines, I want to ask you, can and should the United States take a global leadership role in making sure that those systems and the global order on global health is in place?

Ron Klain: Yeah, we can, we should, we must. Look, we are blessed to have the best doctors, scientists in the world in the US. We are blessed to have in the Centers for Disease Control, the world's leading public health authorities, the world's leading detectives in isolating and finding cases of these kinds of pandemics and epidemics. We're blessed to have at the National Institutes of Health and National Institutes of Allergies and Infectious Diseases, the world's leading scientists doing the world's best research. And all those tools are only useful if we put them to work, not just in our country, but around the world because in the end, the safety of our country, the safety of our people is inextricably intertwined with the safety of the rest of the world. And we're seeing that play out right now in this coronavirus challenge.

Ron Klain: We will bend the curve and beat this disease in the US, but as it continues to rage in Africa and South America, as it spreads throughout Asia, it will come back again, and again and again, unless we help these countries fight the epidemics in their country. And I think that we have to be the global leaders here because it's the right thing to do. It's the humanitarian thing to do, but also because it's the smart thing to do. It's what's going to keep our people safe. If you think back to the Ebola response, in 2014 and 2015, people say, "Well why did the U.S. take such a leadership role? Why did we make the largest deployment ever of CDC personnel overseas? Why did we, for the first time ever, send U.S. military personnel to fight a disease overseas? Why was this our problem?"

Ron Klain: And my answer to that is first and foremost it was our problem because it was a humanitarian crisis and the U.S. is a great nation and we can help other countries and that's what we did with great success in regard to the Ebola Epidemic in 2014, but we did it also because it was the only way to keep the American people safe. If you didn't check Ebola in West Africa, it would have spread to other parts of Africa. It would have spread to adjacent Nigeria, a giant country with a global super city in Lagos. It would have spread from there to Europe. It would have spread from Europe to the U.S. So I mean, I think the only way to keep our country safe is to understand our interconnectedness with other countries and to have a global health security strategy.

Andrew Schwartz: In terms of U.S. global leadership, as we move forward and the United States takes a global leadership role in combating some of these wicked diseases, how does the United States need to confront countries like China and others where the diseases originate from?

Ron Klain: Yeah. So I think there's two things there. One, we need to demand transparency and accountability in all countries on this. That's what the international health regulations to all countries have signed up for require and I think the Chinese unquestionably fell short here. And I think for all of President Trump's tough talk about China, he actually turned a blind eye to that at the critical moment, in December, in January, when we should have been insisting that we get CDC personnel on the ground, into the key places to really understand what was happening, to really get the data firsthand, not have to rely on second hand reports. And I think that we have to demand that all countries be transparent and open about that. The Chinese just weren't here and some of what we're seeing is as a result of that.

Ron Klain: I also think it's important to think about U.S. leadership in this way, which is, in terms of leading this fight, here at home and around the world, and leading other global health security issues around the world. If we don't lead other countries, first of all won't lead as well as we do. So that's a problem. And secondly, our leadership provides us with the scientific and medical learning that protects the American people. I think back to what was going on in West Africa in 2014, where we were on the ground doing research and the Chinese were also on the ground doing research. And the question was who would develop the first Ebola vaccine. Who would acquire the learning that you could only get from being on the front lines for how to prevent and protect people in the future? And because we led so well in that fight, we had the research. We developed the first vaccine. If the Chinese had, maybe they would have access to that vaccine and maybe we wouldn't or we wouldn't know as much about it.

Ron Klain: And so I think we have to understand that each one of these responses is a crisis in and of itself, but it's also about learning for the next one. And we want to have the best knowledge, the best science, the best research in our country to help protect the world and protect our people. And we want to have control of our own destiny and the way to have control of our own destiny is to lead in this field, to learn in this field and to drive the research and the outcomes in this field. That's the best way to keep the American people safe.

Steve Morrison: Getting lost in all of this mayhem is the fact that U.S. leadership has eroded so badly in this period and the stumbles that we've seen have been shocking, not just to us, but to the rest of the world. And restoring that leadership is going to require a pretty special and strategic approach, I think, looking ahead. And we're going to start from a position of deficit, unlike anything we've really seen before. If you could say a few words about that.

Ron Klain: Yeah. I mean look, I think that in this area as in many areas, the past three years, the America First mindset, the isolationist mindset, has served us very poorly. And I understand the appeal of it. The idea that we have problems in our own country, why should we worry about other countries? What do we get out of our investment in these international institutions? What do we get out of our investment in these international agendas? But I think we're seeing, up close and in a critical way, the answer to those questions.

Ron Klain: If we don't invest in global health security, if we don't build the kind of surveillance systems that help us detect diseases around the world, then we're more and more at risk. I mean, I think that whether your particular field of security is military security or climate security or pandemic security, what we know is that the best way to keep the American people safe is to invest in global structures that help identify and respond to these challenges around the world. And if there was some debate or division among the American people about the wisdom of that before this, I hope that the coronavirus crisis is one thing that points to a definitive answer to that.

Ron Klain: If we don't work with our allies to find, detect, isolate and respond to epidemic diseases around the world, then we will continually be at risk here, in this country, and we will continue to see events like the one that's unfolding right now, unfold again. We have the tools to find them early. We have the tools to respond more authoritatively. We have the tools to act more promptly and we just have to invest in them and engage with our allies and our partners around the world in doing that.

Steve Morrison: Are you a little alarmed at the attacks that are being directed from Conservative ranks against Doctor Tedros and WHO itself, in this period, alleging that they were too closely aligned and too forgiving of the Chinese when the Chinese were being very untransparent and very uncooperative?

Ron Klain: Well, I think all institutions deserve to be reviewed and their conduct of this is, and I was critical of WHO in its delay in announcing a public health emergency of international concern. And I myself said, I thought that there was too much influence from China in doing that. But what I will say is, and I think WHO should do better and I think that criticism of WHO is justified. But I also think that we need to be mindful of the fact that we, in this country, also, unfortunately, turned our back on tough action and also allowed the Chinese to obscure the truth and also allowed the Chinese to deny access for our personnel to the country.

Ron Klain: So as late January 24th, President Trump was busy tweeting that the Chinese were doing a great job, that the Chinese were being transparent, that all Americans owed a debt of thanks to President Xi. And so I think there's a lot of scrutiny to go around after this is over. I think there's a lot of scrutiny to go around about who did or didn't get tough on China soon enough and I think asking those questions about WHO is absolutely fair, but asking those questions about the Trump Administration is also quite fair.

Andrew Schwartz: So you mentioned that there's been warnings before and you mentioned that CSIS and others have been part of that. I mean, even back in 2001, CSIS conducted a pretty famous exercise in national security circles called Dark Winter. And it was influential because we briefed Vice President Cheney about six months after we did it and there hasn't been such a sustained interest in Dark Winter over the years because as we passed through global health scare from global health scare, there seems to be a lost interest, but this time around, it's inconceivable that there will be lost interest. What does the next president need to do to ensure that this kind of global leadership you're talking about to keep our self-interest here in the United States, to keep our people safe and to keep the world safe. What has to happen to make sure that all these things are put in place?

Ron Klain: Well first of all, I sadly think it's not inconceivable that there will be lost interest. I mean, I think sadly, the examples you cite and others I could cite, indicate, as Steve alluded to earlier, we have this boom and bust mentality with regard to these public health crises, these epidemic crises, where in the moment we're very focused, we're very intense about it and then the moment passes and we move on. Indeed, we can go all the way back to 1918 in the Spanish flu epidemic and recognize that it was the single largest mass casualty event in American history. What I can tell you is we can go around the country and there are literally hundreds of memorials to World War I and World War II, as there should be, and there's one memorial in this entire country to the people lost by Spanish flu.

Ron Klain: We tend to have this forgetting phenomenon with regard to these epidemics. That was certainly the case, as you say, with Dark Winter after the anthrax attacks in particular. It was the case after SARS. It was the case again even after Ebola. I remember when I assembled the group near the end of the Ebola epidemic and said, "Let's start to work on an after-action report so we can teach lessons learned here." This report now has become public and it's gotten a lot of attention in the New York Times the past couple of weeks. But, the very first meeting of the team to write it, I said, I asked for a show of hands, who had read the after-action report from the last set of outbreaks. The fact of matter is we keep on writing these after-action reports and not acting upon them.

Ron Klain: I hope there's the will after this one to do what we haven't done in the past, which is to take all these studies and reports and analysis and put them to work. What we need to do has been obvious for a long time and remains obvious today. That's to build up a global surveillance and detection system. That's to be prepared with a playbook. Such a playbook existed. The Obama administration left it for the Trump administration as to what to do when a crisis like this breaks out. It's to execute quickly on that playbook. It's to build up our stockpiles. It's to quickly take control of supply chains and get the materials produced, flexed up and distributed. It's obviously to do the things that we need to do to really ramp up the production of therapeutics in a vaccine especially. The key elements are all well known. It's just do we have the will and the organization to do them? Hopefully, this will teach a lesson that we have not learned from past crises.

Andrew Schwartz: Shifting a bit to politics here, Vice President Biden is stuck in the basement, where a lot of us are calling it, when he goes on camera, the basement tapes, referring to, of course, Bob Dylan and the basement tapes, these are the Biden basement tapes. Some Democrats and others are saying, "Well, Biden's not leading enough." What can he do from the basement to help reassure Americans that his leadership going forward will be the right leadership?

Ron Klain: Well, I think you can look at the things he said today. There's a piece out today in the Washington Post that compares his statements from January, February and March to President Trump's statements. It's a stunning contrast of someone who saw this coming early, who laid out actions that needed to be taken early, who laid out a very precise action plan all the way through February and March and who continues to call out today, the steps that need to be taken. I think he's made his views, his perspectives very clear in contrast to President Trump's. In the here and now, what the vice president's doing is a couple of things. First of all, he's tried to bring forward his best advice, his best recommendations for what needs to be done. He specifically has talked about the president making more use of, more than the token use he's made to date, of the Defense Production Act to ramp up our production of masks and gowns, gloves, the protective gear we need, ventilators, all those kinds of things we need. We need more of it.

Ron Klain: And then, to take control of the supply chain and get those materials where they need to be, when they need to be there. He's talked about using the military more extensively. Again, that small uses that have been made to create additional hospital beds and additional facilities to treat the coronavirus cases. We need that so urgently, not just in New York and New Jersey, but increasingly across the country, our hospitals are going to get overwhelmed. Of course, he's addressed from the start, this real gap in testing. There are reports out now that even in places that don't appear to have a lot of coronavirus cases, there are many more than we think. We know that because people are showing up sick in the hospitals with undiagnosed illnesses, largely because we aren't testing and we aren't getting the results back to know what they're sick from. I think this disease has spread across the country. Number of cases is escalating across the country and the vice president has laid out pretty clearly how he would handle this differently than President Trump.

Andrew Schwartz: It's got to be hard for him. Knowing the vice president and knowing his record, he's a people person. He likes to be out talking to people, helping people through crises. He's been through so much in his life and he's really been comforting to people. He's the kind of person who likes to go out and touch lives. How has he been handling this?

Ron Klain: Well, he's been doing what he can do virtually, which is what he is doing. He does, almost every single day, some kind of virtual town hall or engagement with people over streaming platforms. He's constantly trying to talk to people. I also know he's on his phone quite a bit, talking to everyone from the governors who are on the front lines to healthcare workers on the front lines to just individuals he knows who've been touched by this in their families and in their communities. He's providing advice, he's providing leadership, he's providing counsel. I think all those things are useful as we cope with this.

Steve Morrison: What are you finding, Ron, are the most effective means of communicating in this period? Because we've all been thrown into a whole new world here and we're all trying to figure out what's meaningful and effective operating in under these constraints. He has this special challenge obviously and he also has to balance out his desire to speak on behalf of the nation at this time and to hope that we have a more effective response while also being a very accurate critic of the missteps that are being taken by the Trump administration itself. He's got a delicate situation that he faces and has to be very innovative on the communication side.

Ron Klain: Yeah, I think it's really important for him to be clear and transparent as he is being, to reach out to people through interviews that he's doing, through the mass media, through the programs we're producing. He's doing some new and creative things. He's launched his own podcast. I'm sorry you have another competitor, but he's launched his own podcast called “Here's the Deal” that he's putting out an episode each week where he talks to people about this crisis and other issues confronting our country.

Ron Klain: I think it's a mix of old tactics and new tactics. It's a mix of appearing on media interviews, as well as creating some of our own content to try to get his messages across and try to connect with people. I absolutely agree it's a challenge for him in the sense that he does like to be with people. He does like to work the rope line, shake hands, see voters up close and obviously, it's unfortunate that he can't do any of that right now. But I do think he's finding ways to connect with people to get his message out and to try to be helpful, however he can, in this virtual world we all live in now.

Andrew Schwartz: Ron, one of the things that's been praised in terms of creativity in communications is they've had you do some explainer videos about what's going on. Will that continue from the campaign, from surrogates like yourself and from the vice president himself?

Ron Klain: I'm sure we'll do more videos from the vice president, from others. We're going to do, produce all kinds of content around this, around other issues. We're going to do more of the virtual town halls he's been doing. He did one this past weekend with families who were, prominent families on YouTube, hosted by Michelle Kwan. I think you're going to see all kinds of traditional and non-traditional means of communicating with the American people during this period from Vice President Biden.

Andrew Schwartz: The vice president has suggested we might need to go to a virtual convention for the democratic national convention. We've talked about how communications have become innovative and need to be innovative. The president of the United States is on the air every day for at least an hour, sometimes two hours. How important do you think innovative communications are going to be for the Biden campaign going forward?

Ron Klain: Well, look, I think we have been innovative and communicating. We continue to be innovative and communicating and I think that's important. I also think though it's important to understand that voters in November are going to make a big decision about two very different people with very different agendas and very different approaches of leadership, of message, of policy. I think that choice is being made clearer and clearer every day.

Ron Klain: When you hear what the vice president's saying, when you hear what President Trump is saying. And so, I get a little less caught up in the day-to-day cable war battles over this and more focused on the fact that what's shaping up here is one of the most stark, most differentiated, most striking choices that we're going to see in a presidential election between the kind of person and president Joe Biden would be, the kind of person and president Donald Trump would be. I think that choice will be squarely before the American people in November, and I think Vice President Biden will prevail in that choice.

Steve Morrison: I wanted to just focus on the impressive level of organization within the campaign, of expertise in public health and pandemic emergencies. I mean, as I understand it, you have a task force that's drawing from several of the different teams, but you also have a group that's there to advise on the operational realities of how do you go about having elections under these circumstances. Say a bit about how the campaign has gotten itself organized in order to bring forward the right type of expertise in the public health domain particularly.

Ron Klain: Yeah, I think that voters should be reassured that the vice president is consulting on a daily basis with some of the leading figures in public health. Dr Vivek Murthy, the former US surgeon general, David Kessler, former head of the Food and Drug Administration, Rebecca Katz, who's runs a global health program at Georgetown University, Irwin Redlener up in New York, and many others. He's hearing from them every day about the state of the epidemic, what's happening here in our country. He's hearing from them about what are the safe and unsafe things for his campaign to be doing, and so on and so forth. And so, I think he's getting the very best advice that he can be getting and it's shaping both the conduct of his campaign as well as the kind of public policy proposals he's putting forward.

Ron Klain: Obviously, even before we assembled that group, he had top notch advisors in this field from the medical profession, from the Homeland Security field. People like Lisa Monaco, who used to be President Obama's Homeland Security advisor, and others who had been advising him on how to approach the coronavirus epidemic and what policies to put forward for our country, what alternatives to put forward. I think, when the history of this period is written, his leadership both as a candidate and as a person with a point of view about policy will be very strongly vindicated and strongly shown to have been the right course of action.

Steve Morrison: Ron, what's giving you the greatest hope today? I mean this is a really dark moment we're in right now and a dangerous moment, and people are very, very, uncomfortable and fearful right now, for very good reason. I think it's important and we asked this of almost every person that comes on this podcast to tell us where you draw strength and hope in this situation.

Ron Klain: Well, I think there are three real causes for hope right now. I think first, while I have been, justifiably I think, critical of the leadership of the federal response, the rotating cast of characters who've been in charge of the response, the disorganization, the infighting in the administration, it's important to know that the men and women who populate this response, the outstanding career servants in CDC, in FDA, in DHS, in FEMA, in USAID, in CDC, in NIH, all these places, all these agencies, that the people who have been there are still there. They're doing fantastic work. They are the ones who are making the difference. They are the ones who are delivering for the American people. While I wish they had better leadership and organization, I have a lot of confidence in the strength and expertise of this large core of people who've been through this before, many of whom I worked with on the Ebola response. You all know very well they're there and that gives me a lot of comfort.

Ron Klain: Secondly, we do have the best scientists in the world working on therapeutics and vaccines. I think we're going to get results on both those fronts with record speed. Now there are challenges there. Discovering a vaccine is one thing, making 300 million doses and getting it in people's arms is a very different thing. I think, when people talk about the vaccine, we often short circuit the idea that once you have a vaccine, everyone all of a sudden has it. I do think that what we can take comfort from is knowing that we've got the best people in the world at work on these medical research challenges and they're making incredible progress under difficult circumstances.

Ron Klain: And then, finally, I draw great comfort from the strength and resilience of the American people themselves. We've been through a lot of hard things in this country. We've always come through on the other side. We will come through on this one. The toll will be sadly large, larger than it should've been. But, I think we will come through this as a strong and resilient country, and we will get through this to a better place on the other side.

Steve Morrison: Thank you so much, Ron. This has been a really rich conversation and we're really grateful for your leadership and for taking the time to be with us.

Ron Klain: My pleasure. I enjoyed it very much.

Andrew Schwartz: Thanks so much, Ron.