Dr. Alisha Kramer, a CSIS alum and young doctor serving poor, black, pregnant women in Atlanta hospitals, rejoins us for a second podcast. One year into the pandemic, a “new normal” has arisen that is still jarring, a “disconnect” in the changes in medical practice. Vaccine hesitancy is a “shocking” matter among nursing staff. Black persons “have every right to be distrustful” of the health system. If we give the “microphone back to the experts… based on the science,” if we rely on neighbor to neighbor communications, trust will return. We have not yet learned much about Covid-19 infection in pregnant women. It is up to the pregnant individual and her provider to determine whether to go ahead with a vaccine. Her thoughts on her husband Jonathan Ossoff’s successful quest for a Senate seat? “We can all agree 2020 has been incredibly surreal.” Black women in Georgia carried the day.
 
Dr. Alisha Kramer, a revered former colleague at the CSIS Global Health Policy Center, graduated in 2019 from Emory University School of Medicine. She is currently a resident specializing in obstetrics and gynecology at Atlanta public and private hospitals.

Dr. Céline Gounder, a member of the Biden-Harris Transition Covid-19 Advisory Board, takes a look at where we are, less than one week after President Biden assumed power. Deborah Birx and Tony Fauci have each come forward, unshackled, to discuss the moral and professional quandaries they faced, including threats and coercion, as Trump erected false narratives, intensifying in the fall electoral season and beyond, steering Americans into a human catastrophe. “Proximity to power is intoxicating. It corrupts judgment.” “I was impressed by Dr. Birx’s road trip.” It was “a smart pivot.” President Biden has shifted to unification and healing: “That is the way to get to the other side.” It is “calming” when public health and science leaders speak directly to the American people, aided by trusted messengers – the local sheriff, the faith leader, the soccer coach. There was chaos during the vaccine introduction, as the incoming administration was handed a “black box.” The way forward is through continued masking, social distancing, hand washing, along with patience, realism and an optimistic determination in expanding vaccine coverage, amid shortages. 

 
Dr. Céline Gounder is Assistant Professor at the NYU Grossman School of Medicine, President/CEO and founder of Just Human Productions, and host of the Epidemic and American Diagnosis podcasts. She served as a member of the Biden-Harris Transition Covid-19 Advisory Board.

Chef Jose Andres sat down with us to reflect on his life, the organizations he has founded, and his unique, powerful vision for using food to transform communities, battle inequities, advance unity and strengthen economies. When he landed in America as a young man, “I became an American way before I became an American by a passport.” Two years later, at age 23, he chose Washington to be his home: it is the “place where things can happen.” He created relief organization World Central Kitchen to operate in “the limbo between emergency and reconstruction.” “People feel forgotten.” In response to Covid-19 in American and Spain, WCK has served over 36 million meals by partner restaurants converted to community kitchens across America. “We move very quickly.. it is in our DNA.” He has become increasingly convinced that “food is a national security issue” requiring a U.S. “Food Czar” next to the President, with “real power” and a “real budget.” “Hunger is something that cannot wait.” What’s next for 2021? Focus on revitalizing his businesses, the ThinkFoodGroup: “when it is safe.. bring the restaurants back..” Keep moving forward with WCK, changing our national conversation on food. Unity is the key: “I believe in lower walls and longer tables.”

Chef Jose Andres, based in Washington, D.C., is the renowned chef, founder and head of both the ThinkFoodGroup restaurant group and the rapid-response humanitarian organization, World Central Kitchen.

Dr. Luciana Borio, a member of President-elect Biden’s Covid-19 Advisory Group and the transition team, scanned the horizon. On the development of Covid-19 vaccines: “All in all, this has been a spectacular success.” Special tribute goes to the FDA career staff, the “heroes” who charted the path forward. Now most worrying: ensuring large scale manufacturing of the MRNA vaccines, and fixing logistics - “the gaping hole” created by a wholesale lack of planning. Vaccine hesitancy, equity, and the "extraordinary” complexity of delivery all demand high attention. “We don’t have visibility” into the new variants of the virus, due to inadequate genomic surveillance. Development of therapies was hindered by “a lot of noise” surrounding hydroxychloroquine and convalescent plasma: a more rigorous, less political approach will deliver better results. In the next year, while “it’s gonna be hard,” there is “no better team” than the one assembled to begin work on January 20. 

Dr. Luciana Borio is a member of President-elect Biden’s Covid-19 Advisory group and the transition team. She is a Vice President at In-Q-Tel in Washington, DC. She previously served as Director for Medical and Biodefense Preparedness at the National Security Council under both Presidents Obama and Trump.

Chris Murray, the renowned modeler, joined us to share his year-end reflections. In this year unlike any other, Covid-19 pushed modeling onto new ground, as forecasting of individual and governmental behavior became essential to inform decisions in the near to medium term. It’s been “a steep learning curve.” Looking ahead to 2021, in Q1 and 2 we will see a profound pivot, as vaccinations are scaled, winter ends, government policies evolve, and immunity within the population rises. We should arrive at “a surprisingly decent place in June or July.” As we “bounce back to pre-Covid behavior,” it will be a “balancing act.” Success in reaching herd immunity rests on a campaign to get “the maybes,” upwards of 30 percent of the population, while the 15-20 percent of “straight refusers” won’t budge. A vitally important “lingering question:” will we have attained enough vaccine coverage that nothing terrible happens in the winter of 2021-2022?

Chris Murray is the Director of the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.

Steve and Andrew had the good fortune to catch Suzanne Firstenberg shortly after the recent conclusion of her stunning public art installation, ‘In America…. How could this happen?,’ a dramatic tribute to those lost to Covid-19. This “awakening,” comprised of 267, 080 white flags, stood on the parade grounds of the Washington DC National Guard Armory between October 23 and November 30. What motivated her to act so boldly, and how was it possible to succeed so rapidly, moving in just a few weeks from concept to creation? What were the key messages she was conveying, and what was the human experience of those who participated in it? As she explains, she could not do this alone. Several key partners joined with her, most notably Ruppert Landscaping and Jose Andres and World Central Kitchen. Others from the Smithsonian and National Geographic acted to preserve and capture this achievement. 

Suzanne Firstenberg is a social action artist based in Bethesda, Maryland. Her installation was covered by National Geographic, among other outlets, and you can find a Nat Geo video of the installation here.

Dr. Carissa Etienne, Director of the Pan American Health Organization (PAHO), joined Steve Morrison and CSIS Senior Fellow Katherine Bliss for an extended conversation. Why have the Americas become the epicenter of the coronavirus pandemic? What does it signal in terms of deep inequities, weak health systems, and quality of leadership? The region faces cascading crises – debt, extreme poverty, malnutrition, interrupted health services. How are these threats to be blunted? And what role can strengthening primary health care services play? PAHO has a remarkable record of achievement stretching back over a century. How to better make the case to the citizens of the United States of contributions PAHO makes to protecting them? How will the Covax Facility and the PAHO Revolving Fund interact to bring affordable Covid-19 vaccines quickly to the region, at the same time that Russia and China are actively marketing their unproven vaccines to the continent? 

Since 2013, Dr. Carissa Etienne has been Director of the Pan American Health Organization. She previously served as chief medical officer and coordinator of the National AIDS Program in her native Dominica, and as Assistant Director-General for Health Systems at the World Health Organization (WHO). 

A renowned medical and public health voice of compassion, personal advice, pragmatism and vision, Dr. Leana Wen joined us for a tour d’horizon of the pandemic, at this moment of “explosive exponential growth.” Why is it so crucial today to have credible, trusted public health voices? Why have so many Americans disregarded the recent Thanksgiving warnings, and why do so many Americans continue to minimize the threat of Covid-19? The Phase 3 vaccine results are “great news” and we now have to attend to the “serious problem” of distrust, and the risk of asking already highly constrained local and state public health officials to run demanding vaccine programs, with an urgent need for new financing. Solutions take different forms. “Messengers often matter more than message.” On vaccines and restoring trust, there is a need to hear from business leaders, pastors and other religious figures, and Republicans. In many areas – schools, business closures, scientific trials – “moderated” nuanced policies and “radical transparency” of data and decision-making will improve public understanding and support.

Dr. Leana Wen is an emergency physician and Visiting Professor of Health Policy and Management at George Washington University School of Public Health. She is a contributing columnist at the Washington Post, and an on-air commentator for CNN. She served previously as Health Commissioner for the City of Baltimore.

Steve and CSIS Senior Fellow Katherine Bliss enjoined Sir Andrew Witty to help us answer a few fundamental question: what exactly is this new, umbrella coalition, the ACT Accelerator; what is its value, six months after its creation; and what are its true prospects of success in battling hyper-nationalism and enhancing access by low and middle income countries to Covid-19 vaccines, therapies and diagnostics? Along the way, we delved into the significance of the November 21-22 G-20 summit, discussed the finance gap, the prospects of massive vaccine surpluses in the hands of the most wealthy and powerful countries, and China’s participation. Is the door open for the United States to join, belatedly? And what would the special value of that be?

Andrew Witty is the Co-Lead of the Access to Covid Tools (ACT) Accelerator and WHO Envoy for Covid-19. Between 2008 and 2017, he was the chief executive officer of GlaxoSmithKline. He is currently president, UnitedHealth Group, and chief executive officer, Optum.

We sat down with Mike Osterholm, a member of President-Elect Biden’s Covid-19 Advisory Task Force, a renowned leader in global health security, director of the University of Minnesota’s Center for Infectious Disease Research and Policy (CIDRAP). What does he make of this “most dangerous period since the Spanish Flu in 1918,” fueled by “pandemic fatigue, fatigue anger and indoor air?" Health systems are on the edge of breakdown, as shortages of ICU staff and beds worsen, providers “hit the wall” in locating protective gear, and drug shortages worsen. In his view, America needs a leader who can communicate calmly and effectively to all Americans. “We need Uncle Joe,” we need “fireside chats” that “help us get through this.” 

Dr. Michael Osterholm is the founder and Director of the Center for Infectious Disease Research and Policy (CIDRAP) and Professor in the School of Public Health at the University of Minnesota. He is a member of President-Elect Biden’s Covid-19 Advisory Task Force.