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.

In this episode, we are joined by Dorothy Shea, the U.S. Ambassador to Lebanon, along with Jon Alterman, SVP/Director of the CSIS Middle East Program. The Covid-19 outbreak, kicked into high gear following the August 4 Beirut port explosion, is out of control and has triggered a new national lockdown. It is embedded in a web of economic, political and humanitarian crises, which have brought Lebanon to the edge of state failure. Why does Lebanon matter to U.S. national interests? And what impact is the United States having?

Dorothy Shea is the U.S. Ambassador to Lebanon. Jon Alterman is Senior Vice President, Zbigniew Brzezinski Chair in Global Security and Geostrategy, and Director of the CSIS Middle East Program.

In this episode, Jono Quick opens with a sweeping overview of the history of faulty responses to pandemics -- why we “descend into the valley of complacency” so often? What are the essential steps to take now, modeled perhaps after the 9/11 Commission, to remember this profound moment? How do we transcend our divisions, borne of pandemic denial, pandemic fatigue and pandemic anger? He also illuminates the $100m Rockefeller Foundation swift and highly ambitious initiative to press for a national approach on test and trace in the United States. Followed now by the $1 billion three-year Rockefeller Foundation campaign, just unveiled, to catalyze a more inclusive, equitable green recovery from the Covid-19 pandemic. 

Dr. Jonathan (Jono) Quick is the Managing Director for Pandemic Response, Preparedness and Prevention at the Rockefeller Foundation. From 2004-2017, he was President and CEO of Management Sciences for Health (MSH).

Helene Gayle sat down with us to reflect on the expert committee that she and Dr. Bill Foege led recently to map out – in record time – a framework and strategy for the phased introduction of a Covid-19 vaccine in America. For this urgent, complex priority, what are the principles that should guide decisions on who comes first, and who comes later? How best to address gross disparities in the vulnerabilities to Covid-19 of Black, Latinx and Native American populations? What are the essential steps to address widespread distrust and vaccine hesitancy? What comes next, how to navigate the uncertainty and turbulence of these times, and what are the roots of optimism and hope?

Helene Gayle is the President and CEO of the Chicago Community Trust. Previously she was the President and CEO of CARE, and a senior leader at CDC and the Bill and Melinda Gates Foundation. From July through October, she co-chaired with Dr. William Foege the Committee on Equitable Allocation of Vaccine for the Novel Coronavirus, organized by the National Academies of Sciences, Engineering and Medicine. Its final report, ‘Framework for Equitable Allocation of Covid-19 Vaccine,’ was issued October 2, 2020. Helene has been a CSIS Trustee since 2007.

Jennifer Kates and Josh Michaud, Kaiser Family Foundation, joined us to discuss their new analysis, ‘Distributing a Covid-19 Vaccine Across the United States – A Look at Key Issues.’ Getting vaccines to Americans is an unprecedented, gargantuan, complex enterprise. Just how ready are we? Financing thus far is a meager $200 million, while an estimated $6-10 billion will be required. Local public health infrastructure is rickety, insurance gaps are many, and building trust and engagement, especially with Black, Latinx and Native American populations remain essential challenges. Some states have identified early phase, prioritized recipients with some precision. Others lag behind. How to manage this enterprise amid deep partisan divisions, the winter surge, our national electoral process? How to judge the performance thus far of Operation Warp Speed? Give a listen!

Jennifer Kates and Josh Michaud are with the Kaiser Family Foundation in Washington D.C.. Jennifer is the Senior Vice President and Director of Global Health and HIV Policy, Josh the Associate Director of Global Health Policy.