Former Sen. Bill Frist on the President’s Pandemic Response

CHRISTIANE AMANPOUR: Our next guest, a surgeon and former Senate majority leader from Tennessee, doctor senator, Bill Frist, raised the alarm about preparing for pandemics 15 years ago. As majority leader, he helped pass the Bush administration’s landmark emergency plan for AIDS relief, which is called PEPFAR. The 2003 scheme provided more than $80 billion in funding for HIV treatment. And he spoke to our Michel Martin from his farm in Virginia about President Trump’s handling of coronavirus and the vital importance of science, data and contact tracing.

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MICHEL MARTIN, CONTRIBUTOR: Dr. Frist, thank you so much for joining us.

BILL FRIST (R), FORMER SENATE MAJORITY LEADER: Thank you, Michel. Good to be with you.

MARTIN: I read a speech by you that you delivered in 2005 talking about this. I’ve also seen it’s an unclassified report by the intelligence services that was delivered to the administration in January of this year outlining with alarming detail exactly what we’re going through now. It identified exactly there’s likely to be a coronavirus pandemic, that it is likely to result in key shortages of, you know, ventilators and personal protection equipment. Why is our country, the richest in the world, so poorly prepared for this?

FRIST: Well, I think they’re — the two main reasons, one is just a lack of appreciation for science and a real understanding. When — you will remember, when I came to the United States Senate, which wasn’t that long ago, I was the first physician, doctor in the United States Senate, a representative government, in 70 years, over 70 years. And I think, even today, there’s not a full appreciation by our legislators and executive branch for the power of science and the necessity of understanding science, because these viruses, bacteria are going to continue to outrun us over time. The second is just a lack of long-term thinking and that the way our politics is set up, with the immediacy and capturing the whims of the American people and our democracy and our elections, it does mean that people are voting more for short-term solutions, with two-year cycles and campaign cycles. And these viruses and pandemics will emerge every 10 years, every 15 years and every 20 years, and that lack of long-term thinking. And all that really comes back to basic solutions. And that is — maybe this is helped by the pandemic and appreciation that the only thing, the only thing that’s going to bring this pandemic to an end is medical science, and then, also, that people need to get out and vote. They need to vote for people who, in this country, indeed, around the world, who demonstrate an understanding for science, but probably even more important than that, an understanding of being truthful, direct to the American people, with some humility and that long-term thinking that is absolutely necessary.

MARTIN: We talked to a former — a prominent Republican strategist, Stuart Stevens, on this program just a couple of weeks ago. And part of what he had to say is, blame people like him. I mean, he said that people like him, who had taken advantage of this kind of populist movement, which, in some cases, acted as if earned authority was somehow the enemy, that all knowledge is sort of self-contained, that is basically built on anger, inchoate anger, he said, blame people like him. Now, what about you? Who do you blame for this?

FRIST: Yes. No, well, it’s interesting. I kind of blamed myself in that same speech. And I gave the same speech. And people can get it online through The American Mind, which republished it. But, at that time, I said, it is our leadership. And if we don’t act, blame me. At that time, I was majority leader. And I tried hard. And, indeed, the year after I left the Senate, in 2006, a major pandemic bill passed, but it wasn’t the Manhattan Project, which I knew it would be required, in order to have this vaccine discovery and the modeling of the virus. So I think it is right. You have to sort of blame ourselves. But I thought back then, because we had just come off the HIV/AIDS in 2003, the PEPFAR, the greatest investment and most successful investment, I would argue, over the last 30 or 40 years in public health, with a very successful leadership by the United States Senate, House and president the United States, with the world. Today, I worry about U.S. leadership, because we’re retracting, our leaders are retracting from groups like the World Health Organization, not perfect, but how they made mistakes, maybe not fully transparent, but it is the only organization in the world today that has people on the ground that is in most countries throughout the world, that is on six of seven continents on the front line. So I have to blame leadership in part. But the teachable moment that we have — and this is where I’m hugely optimistic — is that we’re coming together today with the greatest scientists in America. The NIH is organizing it. Universities are coming together. Global scientists are coming together for the first time to address this issue. And now that we have, in America, which I think does need to be the world leader here, we have 300 million people who are being affected, who are locked down, who are scared, who are falling into poverty, who aren’t going to be able to put food on the table, and now they understand that we need to act, we need to act long-term.

MARTIN: Dr. Frist, one cannot help but notice that the political speakers that are pushing most aggressively for the states to reopen, in some cases, have declined to even issue stay-at-home orders, are Republican governors. And some of these states are states where the numbers of infections are increasing, the death — the number numbers of deaths are increasing, not decreasing. And, Dr. Frist, I can’t help but notice that some of these states are also the states that have some of the most restrictive abortion policies in the country, the argument there being that this is their duty to protect vulnerable life. How is this pro-life? How is this consonant with those principles to be opening states, when people are still dying?

FRIST: Michel, I think a couple of things. I don’t throw this straight to the political world. And I’m part of the political world. And, as you know, I have run the Republican Senatorial Committee, have been at it a long time. And so I do not go straight to the issues like abortion when we’re talking about this. So, let me tell you the way I look at it, and then we can come back and answer your question. It’s a huge oversimplification that plays well, I guess, on TV and maybe even in politics, to put doctors and public health vs. governors or people who are interested in getting back to work and the economy. It’s sort of a false choice. It’s an oversimplification. And I think a smarter way to look at it is that we have to have containment. Containment is the only way to prevent death and destruction. But is it excessive and costly containment? Or is it more of an affordable containment. Poverty, job loss 30 percent of unemployment has a huge human cost that is — goes beyond just having money to put food on the table, but actually leads to death and leads to depression and leads to suicide. So that’s the pressure that some of these, not just governors, but every small business person listening to us now who says, I don’t know if I can keep my business going for weeks and months, and now you’re talking about six months and a year. So the debate needs to be held.

MARTIN: So, Dr. Frist, the question I have for you, as a person who’s so well acquainted with these facts, are you talking to these governors about this?

FRIST: Yes, I am. I’m talking to the governors. And I’m involved with the mayor just in the end of last week in Nashville, Tennessee, a metropolitan area of about 800,000 people, intimately involved in how you open up a community of 700,000 people based on science, based on metrics, the measurements of not just who dies — that’s way too late — but what the tests can show, can predict, to look at doubling rate of the virus, to look at number of new cases per 100,000 people, and open in a city, in a region, and maybe even in a state, according to data, hard data and metrics. And that’s why we need more tests, to know what that denominator is. And, yes, I have talked to directly to our governor, Governor Lee, one of the first three states talking about opening. And I know it’s thrown in with the media that they’re opening next week. Well, in truth, the governor is saying, the six metropolitan cities in a rural state like Tennessee, I’m not going to govern them. I’m going to have them decide, based on data, hard metrics, as to when to reopen. For the other 84 rural counties where COVID is not increasing for two weeks, yes, I’m going to tell you say, take that shutter off the restaurant, but don’t do it all at once. Have a few people go in with six- foot distancing. Don’t open the bars, have reusable menus. So, this lumping of all the governors to sort of Republican governors of the South together, I think, is not quite as fair as it should be. You need to come and actually look at what is being done.

MARTIN: But the reality of it is, in some places, political figures, state lawmakers, political activists are, in fact, organizing these protests demanding that the states reopen. I mean, the fact is, politics is the means by which government happens. And government is obviously a significant presence in all of our lives. Why is this happening? Why is it that people who otherwise consider themselves, as I understand it, pro-life are pushing to reopen states, when vulnerable people could die as a consequence? You tell me, why is that happening?

FRIST: Michel, you can ask the question, and you can frame it politically. I’m just going to come back and say, I’m a Republican. I’m from a Southern state. I’m from a Southern city. I believe in data. I want to protect lives. I do think the end point is, as you come back to life and life issues, I don’t think — to go to abortion and talking about it to make it political, I’m not going to go there. You can try to force it there. But I will say loss of life is important. It’s absolutely critical. It is ultimately the most important thing to me. And we should not reopen if we’re going to predict loss of life. And that’s where the science and where the data is being gathered, has been gathered. And any sort of reopening needs to be based on wisdom and knowledge and science. And you don’t reopen. And if you do go too far reopening just so people can get back to jobs, again, to get back to putting some money out there, but, if you do reopen, you need to be able to close it right back down if you have made a mistake, if you have gone too far. You can’t stay closed. Right now, we’re going into a great recession right now because of this virus, a great — probably the greatest recession since the Depression that we’re going into it. And it’s not just the United States. Its global. Three — the global economy is going to fall by 3 percent this year and probably 3 percent next year. So it’s not just the United States. Science means we’re not going to have vaccine for another year. And if you propose to keep everything closed totally, nobody at work for a year, the loss of life will be 1,000 times, 1,000 times what this virus is. So let’s come back to science. Let’s see what works. Let’s get the answers to those known unknowns. And if we do it smartly and wisely, we will win this battle, absolutely. But it’s going to take everybody coming together.

MARTIN: And you have highly relevant experience. You’re a former majority leader of the Senate, a prominent figure in the party. Have you talked to President Trump? Have you had the opportunity to share your experience from those days with him?

FRIST: No, I have not. But I will say, I have talked to most of the other leadership, all — basically all the other leadership that is working with him. I have not directly talked to him, but I have talked to people that are working with him and that you see on the stage every night with him.

MARTIN: How is he doing, you think? How is President Trump doing, in your view?

FRIST: Well, you know, I think two things. First of all, it is good to have a president who is every day on the issue. And he is on the issue. He is out there communicating. I think he has got other people up on the stage with him for the science, for the accuracy, and he is turning to them. So, I think that is all very good, very positive. I think, when statements are made not based on science, when there’s specific treatments being proposed to people who are dying or who are scared or who are vulnerable, treatments which are dangerous to them, but they’re — they want to reach out for anything, that that is incorrect and it is wrong. And I encourage people who are on the stage with him to slow that down, to talk to us, hey, don’t do that. I think — so, I think the communication is good and that everybody knows that for an hour, maybe too long, two hours, sometimes three hours, there are people up there talking about it, but I worry about the accuracy of the information.

MARTIN: People who’ve been following the story may be aware that one reason that South Korea, for example, hasn’t had to shut down as thoroughly as other parts of the world have is that they have done aggressive contact tracing. Could you explain what contact tracing is, and why that matters?

FRIST: To fight this enemy that is the virus, we need to know who has the disease, who’s been infected. If we don’t have tests, which we don’t — we don’t know who’s infected, so we’re not really able to fight the enemy. So the lack of testing has been our number one failure. And, as we speak, we still don’t have enough testing. We don’t know who — if you are well today, if you don’t have any disease, oh, you can’t get a test today. And you can’t get an antibody test to say you have had it in the past. And that’s inexcusable. And that, to me, is our number one priority. What we need to do two — we need to do two things. We need as many as 30 million tests a week. We’re only doing about a million tests a week. And coupled with that, we need to do contact testing, contact tracing. And all that means is, if you test positive for the COVID virus, that is, you have the virus now, you need to tell the last 10 people or 10 people who — or 15 people who you have had more than 15 minutes of contact with over the preceding two weeks. That list, you generate. You give it to a person, or technology can be used. Those people need to be contacted, and contacted right now, told that they were in contact and could be infected. They need to get tested. So we need to test, A, and then they need to be quarantined for 14 days if they cannot be tested. That absolutely has to be done.

MARTIN: Americans feel strongly about their privacy. Americans don’t like — A, we don’t like people telling us what to do. And we surely don’t like people telling us who we can associate with and having to report on who we have associated with and so forth. And you know this for a fact, that certain groups are particularly suspicious of people investigating who they have been associating with. I mean, can we conduct this in a way that meets American sensibilities around privacy?

FRIST: The privacy issue is a big issue. But we’re in an emergency. We’re in a life-or-death situation. And we have seen people willing today to sacrifice a little bit of the privacy and their comfort with telemedicine, telehealth, of getting out, of getting — using the Internet to give access to health care is a demonstration of that. But eight weeks ago, they’d say, I’m not going to trust the Internet. I’m not going to trust the Web for that. But now that it’s life or death, they’re trusting it. So, people, A, are willing to give the privacy issues and the privacy hawks who say we can’t do anything a little bit of leeway there. With regard to the testing, because it is so local, right now, if I tell you there’s a 5 percent chance you’re going to die if you’re positive, but I don’t have a test to tell you whether you’re positive, all of a sudden, you start saying, well, privacy is important, but it’s not all that important right now. Go ahead and test me. Put it into a database if you think it’ll help for my mom or my dad or my children, and let’s go for it. After the COVID pandemic settles down, I think we will have to come back and relook at all the privacy regulation for virtual care, for telemedicine, for telehealth, for laboratory data. But we’re in this emergency mode now. I think people will be pretty lenient, because it will be more testing, and contact tracing will be lifesaving, for sure.

MARTIN: All right, I’m going to ask you to put your doctor hat back on. You have never really take it off, but are we going to be OK?

FRIST: Yes, yes. The human body is unbelievable in terms of the biological plasticity of responding and abiding. And that’s why we have this fight-or-flight response. It’s why our immune system has developed as strong as it is. Now, so if we couple that with the very best science in the world — it’s not all here in the United States. The vaccines — as many vaccines are being developed overseas, if we put all of that together, with science — and science will provide the endpoint, the vaccine, the antiviral treatments, coupled with the plasticity and the nimbleness of the human body and the biology, we put that together with what we just talked about, the human spirit and the plasticity of the human spirit, we definitely are going to be OK. It’s going to require patience. It’s going to require humility. It’s going to require honesty. But, with that, we will get through this, and we will win this battle.

MARTIN: Dr. Bill Frist, a former senator from Tennessee, a former Senate majority leader, thank you so much for talking to us. I hope you’re right.

FRIST: Thank you.