Biden COVID Response Team Hopes For “Complete Transparency”

CHRISTIANE AMANPOUR: And next, we are going to talk about more on the global pandemic. No one is fully safe until all are indeed. President Biden has unveiled a new national strategy to replace the ad hoc jumble of responses from 50 different states under the previous administration. Andy Slavit is a senior adviser to the new response team and he was President Obama’s acting chief of Medicare and Medicaid. Here he is now talking to our Hari Sreenivasan about the best way forward.

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HARI SREENIVASAN: Christian, thanks. Andy Slavit, thanks for joining us. First, last time we spoke, you were on the outside looking in. Here you are now part of the group of people advising the president on our COVID response. And first, I guess, you know, there’s been rumors and reports about what your group has inherited. Is there a plan? Was there a plan? Is it half-baked plan? What are you working with?

ANDY SLAVIT, SENIOR ADVISER TO THE COVID RESPONSE TEAM: Well, you know, I don’t want to fixate too much on the negative because I think one of the president’s objectives is, of course, to bring the country together. And to do that, we don’t want to look too far backwards. But, you know, I think there is a reason why things aren’t as far along as we thought. I don’t think there’s the kind of infrastructure and the plan for success that there needs to be. Now, plans aren’t everything. Plans need to be tweaked along the way and the world needs to respond to — back from the ground and changes in science and all of that. But, you know, we are going to have to put in place, and we are starting to put in place, a very clear detailed plan of how we’re going to do things, how important to do things like increase vaccinations. And I think that’s what the American public expects.

SREENIVASAN: Yes. We’ll talk about vaccinations in a minute. I want to also ask, right now, people are very concerned about these new variants that are occurring naturally, that are happening in different parts of the world, even different parts of our country. A variant in Los Angeles, there’s been one found in the Bay Area. These seem more contagious than what we’ve been accustomed to for months and months. How concerned is the taskforce and the response planning for these variants?

SLAVIT: Well, you are right. There are new variants, and there will be new variants, you know, this will a part of the story of this pathogen. And we just have to be better and smarter. What I would say to the public is the same things that were important before we knew about these variants, wearing a mask, as good and as tight- fitting mask as possible, getting vaccinated and understanding why you should be vaccinate. And taking precautions with yourself or your family are just as important if not more important than before. So, in terms of what we would do differently as a public, it’s all exactly the same. Now, the scientific community, and we’re going to let the science continue to tell us what the data says about these things, is going to have to be on it’s — continue to be in its game. You know, it’s not develop a vaccine, game over. It’s continue to look for vaccines, therapies, other adjustments to test and so forth that will naturally occur over time. And I think the good news is, if we are on top of it and get more on top of it, start sequencing more, start testing more, we will not be caught as unaware as I think we were this time.

SREENIVASAN: If this virus mutates, and that’s bound to happen, is there a scenario where we just live with coronavirus year after year and similar to getting a flu shot, we get a coronavirus shot too?

SLAVIT: Well, so, you know, I don’t want to be too much speculate about the future, but I think if you look at the history of viruses, you know, very few are completely eradicated. So, smallpox was eradicated and, you know, polio is quite close. But most viruses we learn to find many, many other means besides just eradication for dealing with. And as we know, sometimes that means booster shots as in the case of influenza, sometimes in the case of HIV, that means cocktails of therapeutics. But we will absolutely be able to bring this under control over time and get back to normal life, but we need a strategy to do it. We need science. We need to pay attention to science. We need transparency. We need to get facts. And if we do those things and really act and get the public to act with us, you know, we will we will do the best job we can defeating this. And whether — what defeating means exactly, as you say, Hari, we don’t exactly know what that looks like, but it probably doesn’t mean complete eradication.

SREENIVASAN: So, what happens if the president says — we’ve got the Defense Production Act going, does that mean that somebody from the White House right now is making calls to a glove manufacturer, PPE manufacturers and saying, hey, listen, I need you to put your assembly lines for other things on hold and make more of these and we want them by yesterday?

SLAVIT: So those are the assessments being made exactly and I think if those things get determined figured out precisely what we need and where we need it, we will see those things. I’ll give you an example, an immediate example. People may be aware that there is an extra dose of a Pfizer that — as what they call it, a sick dose. Well, we’ve needed to create — we needed to ramp up production of a new syringe and that’s one of the things that we are ramping up using Defense Production. I expect we will use it aggressively. I guess I’d say, if I had a message to corporation out there who have capacity, whether it’s disputes vaccine, whether it disputes anything else in the national, good. You know, identify yourself to us. We’re already deeply in conversation with many. But we need to put the whole country together, not just corporations, not states, not the just the federal government, we need to pull as many people together and we’ll (INAUDIBLE) more quickly.

SREENIVASAN: How do you change the culture for millions of people who still find this an intrusion on their personal freedoms?

SLAVIT: We have to listen. You know, I don’t think that we should be in a position where we’re treating people’s concerns as unreasonable, whether their concerns about the vaccine, whether their concerns about wearing a mask, whether their concerns about their small businesses, their bars, their restaurants. So, for one, I think we can’t build trust until we do that. Number two, we have to keep up our end of the bargain. And by us, I mean, the government. So, in other countries, where the government provides some support for small business, for people who are out of work, who are renters, et cetera, that that level of trust gets reciprocated more easily than the situation we face here where people have really had to wonder too much. That’s why the president’s package the $1.9 billion package everyone talks about to help this country recover. It’s so critical. Because, in fact, supports people through a very difficult process but it also communicates the people that the we will have your back, we know you’re going through difficult times, we know we’re asking things of you, we know this is something — we know this is sacrifice, but asking people to sacrifice it’s far different than not asking them and letting people to stew (ph) and make them think that they’re losing face.

SREENIVASAN: Now, when we spoke last and you’ve written about this often, do you think that we can get this under control if we just gave it a solid month, maybe a little bit more? Is that part of the plan?

SLAVIT: So, I think if we adopt the measure that we are all contemplating, 100 days wearing a mask, getting vaccines into 100 million arms in the first 100 days, which are plenty of challenges but we are — want to do that and even more. And to communicate with people in a way that they believe and that they trust about the real data, about real dangers, about health risks, about all of those things, we will make a dramatic impact. Now, things will change and we’ll surprises. We’ll see things like the variant or we’ll run into some (INAUDIBLE) challenges, you know, this will not be smooth, it will be a bumpy road. But we will inform people along the way of the good, of the challenges. And I hope that people come to equate this administration with complete transparency and hard work it takes to get to that place.

SREENIVASAN: One of the Republican pushbacks has been 100 million seems too few, because if you actually just say a 100 million arms, looking at the fact that everybody — most people have to get two shots, that’s just about 50 million people, what do you do after that because that’s where we are in the production pipeline? What do you tell Pfizer and Moderna, Johnson & Johnson, anybody else to say, we need more vaccines fast?

SLAVIT: So, first of all, the commitment that the president made was to — of 100 million vaccine in arms within 100 days. That was made before we had any idea, whether or not this was even possible, but I think it sent a signal that we have to set goals and we have to achieve them, we have to deliver them, or if we don’t, we have to explain what’s going on. But we have to pledge ourselves do that. What it doesn’t mean is that we have a goal of getting to a 100 million and stopping. We have to get vaccines available as quickly as possible to every American who wants them and these many places who want them. That’s why we’re rolling out these federal centers. We’re rolling up 100 federal centers that are going to distribute and deliver vaccines. That’s why we’re ramping up with the pharmacy. That’s why we are going to be working with the governors to help figure out where are the vaccines in their pipeline, how do we improve them and working with the manufacturers to figure out, can we get every additional dose as possible. It’s going to take some time. It’s not the kind of thing to be done overnight. You know, the vision that we all may have add when we heard about from the last administration that there were hundreds of millions ready, there were being produced earlier on, you know, unfortunately, it’s not as — that’s not the case we inherited. But it is what it is. We take where we are and we do everything we can to get as many vaccines out into people as possible.

SREENIVASAN: So, right now, speaking of that pipeline, less than half the vaccine that’s been distributed, I think it’s about 36 million to states has been injected. So, how do we speed that up? I mean, where is the bottleneck here? Is it the federal government not getting it to states fast enough? Is it the states not getting it the hospitals? The hospitals not getting it into patients? What’s the problem?

SLAVIT: So, I’ll start with this. States are frustrated about a couple things. One is, many of them want more vaccines. All of them want at least predictability to know how many vaccines they are getting. They haven’t gotten that. We need to turn that around and give it to them. That’s one of the changes we can make top them. More predictability and then ramp up doses and give them as much transparency as possible. Then we have to look at, at the same time, what’s happening to does that as they go out the door, because we know that, as you say, not every one of them is getting instantly into an arm. So, there are some things we can do. We can open the aperture so that we can get more people eligible for vaccine because some of it may rightly be that the rules are too complicate, that we have vaccine but they’re being held or a too narrow population. Some of it is. Some natural mismatch that’s going to occur. For example, you know, you may have to send back to rural communities or to federally qualified health centers. Now, they may not have been able to efficiently use all the vaccines they get, but it’s still important, Hari, because the thing that we can’t hold down on is making sure that the distribution is equitable. And so, if we put all the vaccines in one hard (ph) and locate place, we could probably vaccinate more people more quickly. But the people that can’t get to that place would not be vaccinated. And most at largely be people of color, low-income people, et cetera. So, you know, we’re going to have to both be as efficient as possible but to be as equitable as possible. We’re also going to need to bounds it.

SREENIVASAN: Is there a data warehouse that is showing you everything you need to see about how the vaccine is absorbed, who’s getting it, who’s not getting it? Do you have that kind of dashboard? Are you building it now?

SLAVIT: Unfortunately, we don’t have the infrastructure that I would like to see. And, you know, I think we have some things. But we have also gaps in our knowledge that — you know, and the good news is, within 24 hours, we identified what those gaps were and called people together and there are people who have wanted to figure out what they are. But as of today, I would love to be able to tell you where every vaccine in the country is in inventory. Everything has been produced where it is. How it’s being distributed. What sites are working. What sites are not working as well. Where we need to provide assistance. So, we’re going to have to partner with the states and we intent to, beginning — actually, with a conversation we’re having with all the governors this coming Tuesday to really make sure that that’s happening in an aggressive and systematic way as possible.

SREENIVASAN: You know, speaking of equitable, last night I exchanged a question or an answer with Jerome Adams, the former surgeon general, and he said his dad is 74. He’s an African-American. Has other comorbidities. But the state that his dad lives in, the age is 75, right. How do you weigh the disparate impact that this virus is having on people of color, with comorbidities and — or is the federal government’s hands tied because this is a state-by-state issue?

SLAVIT: You know, we have to work together on solving this problem that’s why we have a health equity taskforce, that’s why we have a leader of the health equity taskforce that is involved in every decision, every major decision that gets made. Because what happened is, you know, I don’t think the last administration was trying to be inequitable. But I think what we’ve learned in this country is unless you make an explicit specific effort to target people who — to whom things are harder to reach, and I’m not just talking about vaccine, I’m talking about everything, and I’m not even just talking about the pandemic, I’m talking about all of health care. And probably not just all of health care. Then we know that we fail people. Not everybody has equal access or ability, whether it’s transportation or child care or they work — they get paid by the hours and can’t leave their job. So, unless you make an extra effort, you never reach that level of equity. The data that we’ve seen showed that we have a real problem with vaccine in terms of getting them to the communities of color, that it’s going to take a really extended effort. And that’s going to mean very specifically working with groups and places that are going to be able to do that.

SREENIVASAN: You know the president recently said this is going to get worse before it gets better, that we could see 500,000 people dead in another month or so. What should we be bracing for?

SLAVIT: Exactly that. That these things don’t turn on a dime. They will be — there will be continued challenges. But we should also be sure of the fact that we can make a difference. You know, this isn’t a virus that’s beyond our  our understanding. Yes, we will learn more about it. Yes, there will be new variants. But we have the science. And what we need is the will and the support and the unity to come together and do those things. Every time I hear one of those numbers, I hear it two ways. I hear it as a sense of how awful this is and what the human toll has been. But I also hear it as a challenge, as a challenge to not let that happen, to make every death theoretically one of the last ones. Because the only way to honor people who we’ve lost, in my mind, the best way (INAUDIBLE), is to not leave any more people.

SREENIVASAN: Andy Slavitt, thanks so much for joining us.

SLAVIT: Thank you.