[MUSIC] >> Bonnie Erbe: HELLO.

I AM BONNIE ERBE.

WELCOME TO "TO THE CONTRARY", A WEEKLY DISCUSSION OF NEWS AND SOCIAL TRENDS FROM DIVERSE PERSPECTIVES.

WE ARE PRIVILEGED TO HAVE AS OUR WOMEN THOUGHT LEADERS TODAY DR. LEANA WEN.

YOU HAVE BEEN HEARING A LOT FROM HER DURING THE PANDEMIC ABOUT HAVE A PRETTY ISSUES, WHICH HAVE BEEN HER THEME FOR MANY YEARS NOW.

SHE HAS A NEW BOOK OUT CALLED LIFELINES, DOCTOR'S JOURNEY IN THE FIGHT FOR PUBLIC HEALTH.

WELCOME, DR. WEN.

HOW ARE YOU?

>> Dr. Leana Wen: THANK YOU, BONNIE.

IT'S A PLEASURE TO JOIN YOU.

THANK YOU FOR HAVING ME ON.

>> Bonnie Erbe: GOOD TO SEE YOU AGAIN.

SO TELL ME ABOUT THE THESIS OF YOUR BOOK.

WHAT'S IT ABOUT?

>> Manal Omar: WELL, I INITIALLY WROTE LIFELINES, IT DID NOT HAVE THE NAME LIFELINES AT THE TIME.

THE INITIAL NAME FOR THE BOOK WAS PUBLIC HEALTH: SAVE YOUR LIFE TODAY, YOU JUST DON'T KNOW IT.

THE LIGHT THOUGH THE CONCEPT IS THAT PUBLIC HEALTH IS SOMETHING THAT WORKS BUT BY DEFINITION IT'S INVISIBLE, BECAUSE WE HAVE PREVENTED SOMETHING FROM HAPPENING.

THE PROBLEM, THOUGH, IS WHEN SOMETHING IS VISIBLE, IT OFTEN BECOMES THE FIRST THING ON THE CHOPPING BLOCK.

AND SO, THIS NEW PHASE OF A PERSON WHO COULD HAVE GOTTEN LEAD POISONED IF NOT FOR THE HOME REMEDIATION THAT WAS DONE OR THE FACE OF SOMEONE WHO COULD HAVE BEEN SHOT HAD IT NOT BEEN FOR THE COMMUNITY VIOLENCE PREVENTION PROGRAMS THAT WERE IN PLACE.

SO THE EDUCATIONAL OPPORTUNITIES THAT THEY HAD ACCESS TO.

AND SO, "LIFELINES" HELPS TO ILLUSTRATE THIS POINT IN MY INITIAL INTENTION WAS TO PUT THE FACE ON PUBLIC HEALTH, WHICH OF COURSE IN THE TIME OF COVID, WE HAVE REALLY PUT THE FACE ON IT IN A DIFFERENT WAY.

AND SO, PART OF THE BOOK TOO IS TALKING ABOUT MY OWN LIFE STORY, WHICH IN A WAY IS ALSO THE STORY OF PUBLIC HEALTH AND HOW PUBLIC HEALTH IS A SAFETY NET, A LIFELINE, IF YOU WILL, FOR MANY.

>> Bonnie Erbe: NOW, TELL US ABOUT YOUR LIFE STORY WHICH IS A VERY MOVING WHEN AS A CHILD.

YOUR PARENTS AND YOU FROM CHINA AND YOU WERE PANHANDLING AT ONE POINT.

TELL US ABOUT THAT.

>> Dr. Leana Wen: YEAH.

IT WAS ACTUALLY QUITE DIFFICULT PART OF THE BOOK , BECAUSE, AGAIN, I THINK I HAD WANTED TO ILLUSTRATE THE WORK THAT WE DID IN BALTIMORE, IN PARTICULAR, AROUND AROUND REDUCING INFANT MORTALITY AND AROUND THE OPIOID EPIDEMIC, THAT THE PROFESSIONAL WORK IS EASIER THAN WRITING THE VERY PERSONAL STORY.

BUT AGAIN, I THOUGHT THAT WAS AN IMPORTANT PART OF THE STORY TO TELL BECAUSE MY PARENTS AND I CAME FROM CHINA, WE IMMIGRATED TO THE U.S.

WHEN I WAS SEVEN YEARS OLD, JUST BEFORE I TURNED EIGHT.

WHEN WE FIRST CAME, WE HAD ONLY $40 TO OUR NAME.

MY PARENTS, DESPITE WORKING MULTIPLE JOBS, WE HAD A LOT OF TROUBLE MAKING ENDS MEET AND WE ALWAYS WERE VERY CLOSE TO GETTING EVICTED AND THERE WERE TIMES WHEN WE WERE EVICTED.

AND MORE EXPERIENCING HOPELESSNESS.

AND I WANTED TO TELL THAT STORY BECAUSE THERE HAS BEEN THIS PERVASIVE NARRATIVE OF IMMIGRANTS AND HOW WE SOMEHOW ARE USING THE SYSTEM TO OUR ADVANTAGE IN SOME WAY, BUT I WANTED TO SHOW HOW -- LOOK, MY PARENTS, MY FATHER WAS AN ENGINEER IN CHINA AND MY MOTHER WAS A PROFESSOR, THEY CAME TO THE U.S. AND WE WERE ABLE TO SEEK POLITICAL ASYLUM HERE.

BUT IN THE MEANTIME, WE HAD A LOT OF TROUBLE.

MY FATHER WAS CLEANING DISHES IN A RESTAURANT, MY MOTHER WHILE WAS BECOMING A TEACHER HERE IN THE U.S., SHE WAS WORKING AT A HOTEL, WORKING AT A VIDEO STORE.

DATED ALL THESE THINGS BUT WE STILL HAD TROUBLE MAKING OUR RENT.

AND I WENT TO ILLUSTRATE THE DIFFICULTIES THAT IMMIGRANTS GO THROUGH AND ALSO FOR US, THOSE BASIC PROVISIONS INCLUDING HEALTHCARE, INCLUDING PUBLIC EDUCATION.

THEY WERE NOT ENTITLEMENTS.

FOR US, IT WAS WHAT WE NEEDED IN ORDER TO MAKE THEIR WAY HERE AND IN ORDER TO SECURE A BETTER FUTURE FOR ME AND EVENTUALLY FROM A LITTLE SISTER AS WELL.

>> Bonnie Erbe: NOW, TELL ME HOW TO DO -- HOW WERE YOU ABLE TO GET INTO AND GO TO MEDICAL SCHOOL?

>> Dr. Leana Wen: I DID NOT KNOW THAT IT WAS SOMETHING I COULD DO.

I KNEW THAT IT WAS MY DREAM TO BECOME A DOCTOR.

WHEN I WAS YOUNG, I HAD SEVERE ASTHMA AND ACTUALLY OPENED "LIFELINES" WITH THE STORY OF HOW I WATCHED A NEIGHBOR CHILD DIE IN FRONT OF ME WHO ALSO HAD A SEVERE ASTHMA ATTACK.

AND I MEAN, SOMEONE WHO HAD ASTHMA, I KNEW THAT IT WAS FRIGHTENING.

I KNEW IT COULD BE LIFE-THREATENING, BUT I ALWAYS KNEW THERE WAS TREATMENT AVAILABLE.

AND TO WATCH THIS CHILD DIE IN FRONT OF ME BECAUSE HIS GRANDMOTHER WAS TOO AFRAID TO CALL FOR HELP BECAUSE THE FAMILY WAS UNDOCUMENTED AND THEY WERE AFRAID OF WHAT MIGHT HAPPEN IF THE IMMIGRATION OFFICIALS WERE NOTIFIED, I MEAN, I COULD SEE FROM AN EARLY AGE THAT HEALTHCARE SHOULD BE A FUNDAMENTAL HUMAN RIGHTS BUT IT'S NOT REGARDED AS SUCH IN OUR SOCIETY.

AND I WANTED TO HELP CHANGE THAT.

BUT WHEN I ENTERED COLLEGE, I HAD WAS ACTUALLY TOO EMBARRASSED TO TELL ANYONE THAT I WANTED TO BE A DOCTOR BECAUSE I THOUGHT THAT NOBODY WOULD BELIEVE ME.

I THOUGHT PEOPLE WOULD LAUGH AND SAY, BUT WHO ARE YOU TO THINK THAT YOU COULD DO THIS?

BECAUSE, YOU SEE, I WAS NOT RAISED IN A FAMILY WHERE WE KNEW ANYONE WHO WAS A DOCTOR, AS IN -- I MEAN, I KNEW MY PEDIATRICIAN BUT I DID NOT HAVE FAMILY FRIENDS WHO WERE DOCTORS IN THE U.S.

I DID NOT KNOW HOW LITERALLY YOU WOULD GET THERE AND I ATTENDED A LARGE PUBLIC UNIVERSITY WHERE A LOT OF PEOPLE HAD A DREAM TO BECOME A DOCTOR AND I THOUGHT, WHO AM I TO COMPETE WITH ALL OF THESE INDIVIDUALS?

AND SO, I STARTED WORKING IN THE LAB AND WORK-STUDY PROGRAM AND I HAD A PROFESSOR, A MENTOR, DR. RAYMOND GARCIA, WHO WOULD ALWAYS ASK ME, WHAT IS IT THAT YOU WANTED TO DO?

AND I WOULD TELL HIM, I WANT TO BE A LAB TECH, BECAUSE I THOUGHT THAT THAT WAS SOMETHING THAT WAS BELIEVABLE.

I MEAN, I WAS WORKING IN A LAB IN MY PARENTS HAD A FRIEND WHOSE DAUGHTER WAS A LAB TECH.

SO I KNEW WHAT PATTY WOULD NEED TO DO, TO GO TO GET THERE.

IT ACTUALLY TOOK ME YEARS TO TELL DR. GARCIA THAT I WANTED TO BE A DOCTOR AND HE IMMEDIATELY SAID, AH, LET ME INTRODUCE YOU TO MY FORMER STUDENTS ARE NOW IN MEDICAL SCHOOL.

AND THEY CAN HELP YOU.

AND IF I DID NOT MEET THEM, I WOULD NOT HAVE LEARNED ABOUT THE UNWRITTEN RULES OF THE ROAD, SOMETHING AS BASIC AS TAKING A CLASS BEFORE I TOOK MY AND MCATS THAT THEY ALSO DID VOLUNTEER EXPERIENCE NOT JUST IN THE COMMUNITIES I WAS DOING, BUT SPECIFICALLY IN THE ER OR IN THE HOSPITAL, BECAUSE THAT'S WHAT MEDICAL SCHOOLS WERE CONSIDERING.

BY THE WAY, EVEN AFTER I HAD ALL OF THEM, I HAD PRETTY GOOD TEST SCORES AND GRADES, I REMEMBER GOING TO MY CAREER COUNSELING OFFICE AND THEY SAID TO ME, EVERY YEAR, THERE ARE DOZENS, HUNDREDS OF STUDENTS FROM OUR SCHOOL WHO HAVE SIMILAR GRADES AND TEST SCORES AS YOU.

THEY APPLIED 41 MIDDLE SCHOOL SCHOOLS AND THEY DON'T GET INTO ANY.

I WAS SO DEVASTATED AT HEARING THIS.

I SAID, TOLD THE STORY TO DR. GARCIA AND DOCTOR GARCIA SAID TO ME, IN THAT CASE, YOU HAVE TO APPLIED 41 MEDICAL SCHOOLS.

AND SO, I SAY THIS BECAUSE I HAVE BEEN SO FORTUNATE OF THE COURSE OF MY LIFE TO HAVE EXTRAORDINARY MENTORS WHO BELIEVED IN ME WHEN I DID NOT BELIEVE IN MYSELF.

AND THIS IS WHY I AM SO DRAWN, KEEP ON COMING BACK TO ACADEMIA, BECAUSE I WANT TO BE THIS KIND OF MENTOR TO OTHERS TOO.

>> Bonnie Erbe: BUT WHY DID HE SAY YOU HAVE TO APPLIED TO 41?

FIRST OF ALL, IT'S EXPENSIVE TO APPLY.

A LOT OF LOW-INCOME PEOPLE ARE REALLY HAMPERED BY ITS SOMETIMES $1000 DEPENDING ON THE SCHOOL OR THE UNIVERSITY PER APPLICATION.

SO WHY DID HE SAY YOU HAD TO DO THAT AND HOW DID IT END UP?

>> Dr. Leana Wen: WELL, HE SAID 41 IN RESPONSE TO THIS CAREER COUNSELING OFFICE THAT SAID TO ME, ALL OF THE STUDENTS APPLIED 40 MEDICAL SCHOOLS AND THEY DON'T GET INTO ANY WHO HAVE -- HE SAID IN THAT CASE, JUST APPLY TO 41 MEDICAL SCHOOLS.

WELL, AGAIN, I FOLLOWED HIS ADVICE IT WAS, BY THE WAY, UNIMAGINABLE TO ME TO THINK ABOUT THE KIND OF DEBT THAT YOU NEEDED TO GO INTO MEDICINE.

I MEAN, I, AGAIN, CAME FROM THE BACKGROUND, FROM THE BACKGROUND THAT WE DID WE DO NOT HAVE A MORTGAGE, RIGHT, WE DID NOT OWN A HOUSE.

SO THE IDEA OF TAKING OUT A LOAN IN SOME CASES FOR OVER $20,000 FOR MEDICAL SCHOOL, IT WAS JUST -- THAT WOULD HAVE BEEN A TOTAL NONSTARTER.

SO I DECIDED TO APPLY ONLY TO PROGRAMS THAT OFFER FULL TUITION AND LIVING EXPENSES.

AND, AGAIN, MY THOUGHT WAS IF I DID NOT GET IN, I COULD NOT JUST GO TO MEDICAL SCHOOL.

AND AT THE TIME I WAS NOT YET A U.S. CITIZEN.

AND I CANNOT QUALIFY FOR A NUMBER OF LOAN PROGRAMS.

AND SO, AGAIN, I THINK CIRCUMSTANCES INTERVENE, BUT I ALSO WAS LUCKY TO HAVE HAD ASSISTANT MENTORSHIP.

AND BY THAT POINT, I HAD MET ENOUGH PEOPLE WHO COULD TELL ME ABOUT HOW TO NAVIGATE THE MEDICAL SCHOOL ADMISSIONS PROCESS.

AND SO, I ENDED UP IN MEDICAL SCHOOL AT WASHINGTON UNIVERSITY IN ST. LOUIS AND THEN I SUBSEQUENTLY, I THINK IN MIDDLE SCHOOL, I ALSO REALIZED THAT MY PASSION WAS IN PUBLIC HEALTH AND HEALTH POLICY, BECAUSE I WAS SEEING ALL THESE INDIVIDUALS, ALL THESE PATIENTS WHO WERE ILL, NOT NECESSARILY BECAUSE OF SOMETHING THAT WE COULD FIX IN THE HOSPITAL, BUT WHO NEEDED SOMETHING ELSE, AS IN I TALK IN "LIFELINES", FOR EXAMPLE, ABOUT A PATIENT WHO HAD A SEIZURE FOR SUCH A LONG TIME THAT HE WAS IN A COMA.

HE WAS A YOUNG MAN WHO HAD LITTLE KIDS.

AND THE REASON HE HAD THIS LIFELONG SEIZURE, HE HADN'T KNOWN SEIZURE DISORDER, BUT IN THE DAYS BEFORE THE AFFORDABLE CARE ACT, HE COULD NOT GET HEALTH INSURANCE.

AND HE COULD THEREFORE NOT AFFORD TO SEIZURE MEDICATIONS.

I MEAN, HE WAS BASICALLY DYING FROM SOMETHING THAT WAS ENTIRELY PREVENTABLE.

AND IN THIS CASE, HE DIED AND LEFT BEHIND HIS LITTLE KIDS WHO WILL NEVER KNOW THEIR FATHER, NOT BECAUSE THE MEDICINES DID NOT EXIST, BUT BECAUSE HE DID NOT HAVE ACCESS TO THEM IN THIS COUNTRY.

THAT IS UNJUST IT IS MY PASSION TO NOT ONLY HELP MY PATIENTS WHEN THEY COME TO ME CLINICALLY WITH WHAT THEY NEED MEDICALLY, BUT ALSO TO BE ABLE TO ADVOCATE FOR THEM INTO WORK IN THIS BROADER WAY TO IMPACT YOUR HEALTH?

>> Bonnie Erbe: NOW, HOW HAVE YOU SEEN PUBLIC HEALTH WORK WELL, AND WHERE HAS IT WORKED POORLY, WITH THE CORONAVIRUS PANDEMIC?

>> Dr. Leana Wen: WELL, EVEN BEFORE COVID, AND ACTUALLY MOST OF "LIFELINES" TALKS ABOUT MY BOOK OR MY EXPERIENCE LEADING BALTIMORE'S HEALTH DEPARTMENT.

I TALKED, FOR EXAMPLE, ABOUT HOW OUR WORK TO REDUCE OPIOIDS RESULTED IN MORE THAN 3000 LIVES BEING SAVED IN A THREE-YEAR PERIOD AND HOW BY WORKING TOGETHER WITH OVER 150 PUBLIC AND PRIVATE PARTNERS WE WERE ABLE TO REDUCE INFANT MORTALITY IN OUR CITY RIGHT 38 PERCENT IN A SEVEN YEAR PERIOD AND, CRITICALLY CLOSE THE GAP BETWEEN BLACK AND WHITE INFANT MORTALITY BY OVER 50 PERCENT IN THAT TIME.

SO I'M PROUD OF THE WORK THAT WE DID AND I THINK THAT IS IN NO WAY A COUNTER POINT, RIGHT?

THAT'S THE COUNTER POINT OF PEOPLE WHO SAY, WELL, WHAT DOES PUBLIC HEALTH DO?

WE CAN SHED ESSENTIAL EXAMPLES OF HOW PUBLIC HEALTH SAVES LIVES AND CHANGES LIVES AND LEVELS THE PLAYING FIELD OF INEQUALITY.

WHEN IT COMES TO COVID SPECIFICALLY, PUBLIC HEALTH IN GENERAL HAS FAILED.

I MEAN, COVID ITSELF IS A MANIFESTATION OF THE FAILURES OF PUBLIC HEALTH AND I THINK THE ULTIMATE REASON IS THAT PUBLIC HEALTH DEPENDS ON PUBLIC TRUST.

AND WHEN PUBLIC TRUST IS BROKEN, IT IS VERY HARD TO REGAIN.

WELL, HOW IS PUBLIC HEALTH TRUST OR HOW IS THAT TRUST FRACTURED IN THE FIRST PLACE?

IN LARGE PART, IT WAS BECAUSE OF LACK OF CONSISTENT COMMUNICATION.

>> Bonnie Erbe: POLITICS.

>> Dr. Leana Wen: YEAH, AND WHEN BASIC MEASURES LIKE MASK WEARING, I MEAN, SURGICAL MASK IS WHAT HEALTHCARE PROFESSIONALS HAVE BEEN WEARING FOR YEARS.

WE'VE KNOWN ABOUT THE IMPORTANCE OF MASKING SINCE THE FIRST PANDEMIC, THE SINCE THE FIRST PANDEMIC, THE 1918, 1919 MAJOR FLU PANDEMIC.

HOW HAS THAT BECOME SUCH A POLARIZING ISSUE?

OR VACCINES, WE HAVE REQUIREMENTS FOR CHILD IMMUNIZATIONS IN ALL 50 UNITED STATES.

WHY IS THE COVID VACCINE SEEN AS SOMETHING SO DIFFERENT?

I THINK YOUR POINT, I THINK THE FACT THAT THERE HAVE BEEN MANY PEOPLE WHO FOR THEIR OWN IN ORDER TO BENEFIT THEMSELVES AND SOME WE HAVE SOUGHT TO MAKE PUBLIC HEALTH A PARTISAN ISSUE IS EXTREMELY CONCERNING.

>> Bonnie Erbe: OKAY.

IS VERY CONCERNING, BUT -- AND YOU ARE CERTAINLY A BIG SUPPORTER OF THE BIDEN ADMINISTRATION WHEN IT FIRST STARTED WITH -- WHEN A FIRST CAME IN AND THE CHANGES IN PUBLIC HEALTH POLICY FROM THE TRUMP ADMINISTRATION TO THE BIDEN ADMINISTRATION.

HOW DO YOU THINK NOW, MANY MONTHS INTO THE PANDEMIC AND WITH THE VARIANCE HAVING SHOWN UP, HOW WOULD YOU GRADE THE BIDEN ADMINISTRATION IN ITS PUBLIC HEALTH POLICIES?

>> Dr. Leana Wen: YEAH AND IT'S AN INTERESTING QUESTION.

LOOK, I'M GOING TO GIVE YOU AN ANSWER TO THIS AND I THINK IT'S ONE THAT MAYBE NOT EVERYBODY IS GOING TO AGREE WITH, BUT, YOU KNOW, THAT'S THE WAY THAT THINGS GO.

I WOULD GIVE THE BIDEN ADMINISTRATION AND LETTER A FOR EFFORT BUT A B- IN EXECUTION AND DELIVERY.

HERE'S WHAT I MEAN: THERE'S NO QUESTION THAT THE BIDEN ADMINISTRATION RECOGNIZES THE IMPORTANCE OF HAVING SCIENTISTS LEAD.

THERE IS NO QUESTION THAT THEY HAVE DONE INCREDIBLE WORK AND HAVE PUT IN AMAZING EFFORT WHEN IT COMES TO ENSURING THAT WE HAVE ADEQUATE SUPPLY OF THE VACCINES AND WORKING WITH LOCAL STATE OFFICIALS -- LOCAL AND STATE HEALTH OFFICIALS TO DELIVER THE VACCINES SO THAT BY APRIL, BY MAY, CERTAINLY, EVERYBODY WHO WANTED ACCESS TO THE VACCINE WAS ABLE TO ACCESS IT.

THAT'S REALLY INCREDIBLE AND I ALSO LOVE THAT THEY HAVE PRIORITIZED HEALTH EQUITY, THAT EQUITY IS EMBEDDED AS A METRIC, AS AN OUTCOME IN ALL THEIR WORK.

I MEAN, THAT'S SOMETHING WE HAVE NOT SEEN ANY ADMINISTRATION BEFORE AND I THINK IT'S CERTAINLY VERY IMPORTANT.

HERE'S THE PROBLEM, THOUGH: THEY HAVE REALLY SUFFERED SOME ISSUES WITH MESSAGING AND COMMUNICATION.

I THINK THE SINGLE BIGGEST MISTAKE THAT THE BIDEN ADMINISTRATION COMMITTED WHEN IT COMES TO THE COVID-19 PANDEMIC IS BACK IN MAY WITH THE CDC ESSENTIALLY SAYING, HEY, VACCINATED PEOPLE DON'T NEED TO WEAR MASKS.

BUT SINCE WE DON'T HAVE ANY KIND OF PROOF OF VACCINATION SYSTEM, THAT RESULTED IN EVERYONE UNDERSTANDING IT AS, WELL, MASK MANDATES CAN NO LONGER APPLY.

AT THAT TIME, LESS THAN 40 PERCENT OF AMERICANS WERE FULLY VACCINATED.

IT WAS WAY TOO SOON TO LIFT MASK MANDATES.

AS A RESULT, THAT ALLOWED THE DELTA VARIANT TO TAKE HOLD IN THE TO TAKE HOLD IN THE U.S. WE ARE NOW AT THE TIME OF THE SPEAKING FACING MORE THAN A THOUSAND DEATHS PER DAY.

WE ARE SEEING THE WORST OF THE SURGE SINCE COMPARED TO -- EXCEPT FOR THE HORRIBLE WINTER SURGE.

RIGHT NOW WE ARE HAVING 2.5 TIMES THE LEVEL OF HOSPITALIZATIONS OF THE LAST LABOR DAY AND NEARLY TWICE THE NUMBER OF DEBTS COMPARED TO LAST LABOR DAY AND WE HAVE LIFE-SAVING VACCINES.

THEN THE BIDEN ADMINISTRATION TRIED TO WALK THIS BACK, BUT IT'S TOO HARD TO PUT THE TOOTHPASTE BACK IN THE TUBE AND I ACTUALLY THINK THAT THEY ARE NOW EMBRACING, FINALLY, SOME TYPE OF VACCINE REQUIREMENT BUT STILL NO PROOF OF VACCINATIONS.

IN A WAY IT'S A LITTLE BIT TOO LITTLE, TOO LATE.

>> Bonnie Erbe: DO YOU THINK THINGS WILL GET WORSE?

ARE WE GOING TO HAVE ANOTHER SURGE LIKE WITH THE VARIANCE THE WAY WE HAD WITH COVID-19, THE DELTA VARIANT?

ARE THERE OTHER VARIANTS CALLING ALONG THAT WILL KEEP CREATING THESE KINDS OF PUBLIC HEALTH AND ONE COULD SAY ECONOMIC DISASTERS FOR THE COUNTRY?

>> Dr. Leana Wen: I'M GLAD YOU EMPHASIZE THAT THIS IS AN ECONOMIC ISSUE AS WELL, BECAUSE SOMETIMES WE WANT TO SEPARATE THIS AND SAY, OH, THIS IS JUST A HEALTH ISSUE.

BUT ACTUALLY, THIS IS PREVENTING ORCHIDS FROM BEING BACK IN SCHOOL SAFELY, THIS IS PREVENTING PEOPLE FROM FEELINGS IF IT WERE, PREVENTING PEOPLE FROM TRAVELING, FROM GOING TO RESTAURANTS, FROM HELPING OUR ECONOMY TO RECOVER.

AND SO, IT CERTAINLY IS A WHOLE SOCIETY PROBLEM AND THAT REQUIRES, FIRST AND FOREMOST, A PUBLIC HEALTH RESPONSE.

TO YOUR QUESTION ABOUT VARIANTS, WE WILL HAVE MORE VARIANTS THIS IS WHAT VIRUSES DO.

VIRUSES MUTATE.

THE QUESTION IS NOT ARE WE GOING TO HAVE MORE VARIANTS, WE DEFINITELY WILL HAVE VARIANTS.

THE QUESTION IS THREE THINGS: WHAT WE HAVE A VARIANT THAT'S MORE CONTENTIOUS, MORE VIRULENT, MORE DEADLY, AND THAT MAY FURTHER EVADE THE PROTECTION OF OUR VACCINES?

THE DELTA VARIANT IS FAR MORE CONTAGIOUS AND ALSO MORE VIRULENT.

IT DOES APPEAR TO WORK -- VACCINES THAT WE HAVE SEEM TO WORK A LITTLE BIT LESS WELL AGAINST THE DELTA VARIANTS, BUT IT STILL SEEMS TO WORK AGAINST THE DELTA VARIANT.

CAN WE HAVE SOMETHING IN THE FUTURE THAT IS ALL THREE THAT MAKE.

OUT THE DELTA VARIANT THAT'S EVEN DEADLIER AND THAT MAY EVADE THE PRODUCTION OF OUR VACCINES?

IT'S CERTAINLY POSSIBLE.

THE BEST WAY FOR US TO REFUND FROM GETTING TO THAT POINT IS GETTING EVERYBODY VACCINATED THE DOW, AND OUR BEST HOPE FOR WARDING OFF ANOTHER SURGE, SCRATCH, THE WINTER, BECAUSE THIS CORONAVIRUS IS A WINTER RESPIRATORY VIRUS, HARVEST HOPE FOR DOING THAT IS DEFINITELY GETTING AS MANY PEOPLE EXITING IT NOW AS POSSIBLE.

>> Bonnie Erbe: AND AS A DOCTOR, IF YOU HAD A PATIENT IN YOUR OFFICE WHO SAID I'M NOT GETTING VACCINATED, I DON'T BELIEVE IN IT OR I DON'T BELIEVE IT IS SAFE OR WHATEVER REASONS THEY COME UP WITH, WHAT DO YOU SAY TO THAT PATIENT?

>> Dr. Leana Wen: ON AND INDIVIDUAL LEVEL, WHETHER WE ARE TALKING TO A PATIENT OR WHETHER WE ARE TALKING TO A FRIEND OR LOVED ONE, THE ANSWER IS THE SAME, OR AT LEAST THE APPROACHES THE SAME, IN WHICH WE HAVE TO APPROACH PEOPLE WITH COMPASSION AND NOT WITH JUDGMENT.

WE NEED TO LISTEN TO THEM AND FIGURE OUT WHERE THEY ARE COMING FROM.

FOR EXAMPLE, IF I JUST STARTED TALKING TO MY PATIENT AND STARTED SAYING, HERE IS WHY IT IS SAFE AND WHY IT'S EFFECTIVE, THAT'S NOT GOING TO CONNECT IF THAT PERSON HAS A SPECIFIC CONCERN.

FOR EXAMPLE, SOMEBODY MIGHT THINK THAT THE VACCINE IS GOING TO GIVE THEM CORONAVIRUS.

WELL, THEN WE CAN EXPLAIN, THIS VACCINE DOES NOT CONTAIN A LIVE VIRUS.

THAT'S NOT GOING TO HAPPEN.

OR IF THEY HAVE A CONCERN ABOUT FERTILITY, WE CAN SAY, HERE I COME HERE ALL THE STUDIES TO SHOW THAT IT DOES NOT HAVE AN IMPACT ON FERTILITY AND HERE'S HOW THIS RUMOR GOT STARTED, AND IT WAS BECAUSE OF ANTI-VACCINE ACTIVISTS WHO STARTED THIS RUMOR.

I MEAN, WHAT EVER PEOPLE'S CONCERNS ARE, WE NEED TO UNDERSTAND WHAT THEY ARE AND THEN ADDRESS THEM.

THIS LEADS TO AN IMPORTANT POINT THAT THE MESSENGER OFTEN IS AS IMPORTANT AS THE MESSAGE.

THAT IS A CORE TENANT IN PUBLIC HEALTHN THIS SENSE, WHAT I MEAN IS THAT SOMETIMES WE MAY NOT BE THE MOST CREDIBLE MESSENGERS TO THE PEOPLE IN OUR LIVES WHO MAY HAVE CONCERNS ABOUT THE VACCINE, BUT SOMETIMES WE MIGHT BE, AND ACTUALLY, I WOULD GUARANTEE THAT FOR EVERY ONE OF YOU VIEWERS OUT THERE, YOU ARE THE MOST CREDIBLE MESSENGER TO SOMEONE.

WEATHERATE A COUSIN OR A NEPHEW OR A COWORKER, THERE IS SOMETHING WE CAN DO TO HELP TO CHANGE PEOPLE'S MINDS.

>> Bonnie Erbe: HOW WOULD YOU RATE PRESIDENT BIDEN ON HIS MESSAGING?

>> Dr. Leana Wen: I THINK THEM RESEARCHING HIS CERTAINLY GOTTEN BETTER.

WAS VERY CONCERNED ABOUT WHAT IT WAS FROM BACK IN MAY INTO THE CDC'S MESSAGING, BUT ALSO PRESIDENT BIDEN'S MESSAGING.

FOURTH OF JULY, PRESIDENT BIDEN HAD AN EVENT AT THE WHITE HOUSE THAT WAS A BIG CELEBRATION EVENT.

SUPPOSED TO CELEBRATE FREEDOM IN PART FROM THE VIRUS, BUT VACCINATIONS WERE NOT REQUIRED.

PRESIDENT BIDEN WAS SAYING AT THAT TIME, IF YOU ARE VACCINATED, YOU ARE PROTECTED WHICH IS NOT TRUE, WAS NOT TRUE AT THE TIME, IS NOT TRUE NOW AND I THINK GAVE THE FALSE IMPRESSION THAT IF YOU ARE VACCINATED, YOU SHOULD NOT CARE IF OTHERS AROUND YOU REMAIN UNVACCINATEDHAT WAS A REALLY DANGEROUS MESSAGE TO HAVE, BECAUSE IT'S ADJUSTED THEM -- IT DOES NOT MATTER WHAT THE REST OF US DO, IT DOES NOT MATTER ABOUT ALL THE UNVACCINATED WHEN IN FACT IT VERY MUCH AFFECTS US.

THEIR BREAKTHROUGH INFECTIONS.

THE MORE VIRUS THERE IS AROUND US, THE MORE LIKELIHOOD WE HAVE OF HAVING A BREAKTHROUGH INFECTION AND SO FORTH AND OF COURSE THERE ARE UNVACCINATED CHILDREN.

I HAVE TWO LITTLE KIDS AGES 1 AND 4.

THEY SHOULD NOT HAVE TO PAY THE PRICE FOR PEOPLE DECIDING THAT THEY WANT TO REMAIN UNVACCINATED.

>> Bonnie Erbe: WELL, THAT'S ANOTHER THING I WANTED TO ASK YOU, IS YOU SAID TO SPEAK TO PEOPLE, THE SO-CALLED ANTI-VAXERS, WITH COMPASSION.

BUT WHY SHOULD, WHEN THEY GET -- IF THEY HAVE NOT BEEN VACCINATED AND THEY GET THE COVID-19 OR THE VARIANT, WHY SHOULD THE PUBLIC PAY FOR THEIR HEALTHCARE?

WHY SHOULD, IF THEY ARE ON PUBLIC, YOU KNOW, ONE OF THE OBAMA CARE PLANS, WHY SHOULD THEY HAVE THOSE COSTS COVERED WHEN IT WAS EASILY AVOIDABLE TO BEGIN WITH?

>> Dr. Leana Wen: YOU KNOW, GOOD QUESTION.

I THINK THERE ARE A LOT OF PEOPLE WHO ARE DEBATING THIS FROM A POLICY PERSPECTIVE.

I WILL SAY THAT FROM A CLINICAL PERSPECTIVE, THAT'S DIFFERENT.

SO A DOCTOR TREATING A PATIENT IS VERY DIFFERENT FROM THE GOVERNMENT MAKING POLICY FOR PEOPLE.

A DOCTOR TREATING AN INDIVIDUAL PATIENT, IT IS NOT OUR JOB TO BE JUDGE AND JURY.

WE SHOULD NOT HAVE TO EVER DECIDE, OR WE COME TO TREAT THIS PERSON OR NOT TREAT THIS PERSON?

THAT'S NOT WHAT WE DO.

SOMEBODY COULD COME IN WHO IS A SUSPECTED TERRORIST OR MURDERER.

WE DON'T MAKE THE DECISION ABOUT WHETHER THEY GET CARE.

WE TREAT EVERYBODY DEPENDING ON THE CONDITIONS OF THEY HAVE AND NOT ON WHAT THEY MAY OR MAY NOT HAVE DONE.

BUT THAT'S A SEPARATE QUESTION FROM WHAT HAPPENS ON A POLICY LEVEL.

THERE ARE DEBATES GOING ON -- >> Bonnie Erbe: LET ME IN IRAQ FOR A SECOND, BECAUSE I READ AN INSTANCE OF A MAN -- I DON'T REMEMBER WHAT STATE THIS WAS IN, BUT HE HAD HEART PROBLEMS AND THE HOSPITALS NEARBY HIM WERE SO OVERFLOWING WITH -- >> Dr. Leana Wen: YES, ALABAMA.

>> Bonnie Erbe: RIGHT, AND HE DIED FROM HEART DISEASE THAT EASILY COULD HAVE BEEN, HE COULD'VE GOTTEN A STENT OR SOME KIND OF SOMETHING COULD HAVE BEEN DONE IN THE HOSPITAL TO SAVE HIM AND HE DIED.

>> Dr. Leana Wen: RIGHT.

>> Bonnie Erbe: WHY SHOULD PEOPLE LIKE THAT GUY THE HOSPITALS ARE AT LEAST PARTIALLY FILLED BY PEOPLE WHO WEREN'T VACCINATED?

>> Dr. Leana Wen: RIGHT.

I MEAN, THAT'S A SOCIETAL QUESTION, RIGHT?

THAT'S A POLICY QUESTION.

AND I'M NOT -- I THINK THIS IS HORRIBLE.

I WAS WRITING ABOUT THIS, IN FACT, THAT THIS IS A 73-YEAR-OLD GENTLEMAN WHO HAD A CARDIAC EMERGENCY.

HIS HOME HOSPITAL CALLED 43 OTHER HOSPITALS IN THREE STATES AND WERE UNABLE TO FIND HIM CAREHERE WAS ANOTHER INSTANCE OF A MAN IN HIS 40s, AND ARMY VETERAN WHO SERVED TWO TOURS IN AFGHANISTAN, WHO HAD GALLSTONE PANCREATITIS.

I'VE NEVER SEEN ANYONE DIE FROM GALLSTONE PANCREATITIS, OKAY.

THIS IS A TREATABLE CONDITION.

IS DR. KHAN AROUND FOR SEVEN HOURS TO SEE IF THEY COULD FIND A BED FOR HIM SOMEWHERE.

THEY COULD NOT.

HE DIED.

I MEAN, IT'S NOT JUST CARE FOR COVID PATIENTS THAT ARE SUFFERING, IT'S TREATMENT FOR PEOPLE COMING IN WITH ALL THESE OTHER ISSUES.

PEDIATRIC ICU SO GETTING FILLED.

THERE ARE CHILDREN WHO MAY NOT BE ABLE TO GET CARE BECAUSE OF THE ISSUES THAT ARE THEN DUMPED ON THEM BY ADULTS, BECAUSE ADULTS HAVE NOT DONE THEIR DUTIES TO GET VACCINATED.

EMILY, I VERY MUCH TAKE YOUR POINT THAT THIS IS SOMETHING AFFECTING INDIVIDUALS OR SAYING NOW I THINK YOU'RE HEARING FROM A LOT OF VACCINATED PEOPLE WHO ARE FED UP, SAYING WHY AM I BEARING THE RESPONSIBILITY AND HAVING THE COST OF SOMEBODY ELSE'S DECISION UP TO BECOME VACCINATED?

THAT'S ABSOLUTELY A MAJOR PROBLEM AND I THINK WE AS A SOCIETY HAVE TO WRESTLE WITH THAT.

BUT I THINK THAT'S ALSO WHY -- I MEAN, I'M VERY MUCH IN FAVOR OF VACCINE MANDATES FOR EXACTLY THIS REASON, BECAUSE THIS CANNOT JUST BE SEEN AS AN INDIVIDUAL DECISION TO ME REMAIN UNVACCINATED.

>> Bonnie Erbe: AND FINALLY, DO YOU THINK WE WILL GET A COVID VACCINE IN A COUPLE YEARS, IT WILL BE A MATTER OF COURSE TO GET A COVID VACCINE ALONG WITH YOUR REGULAR WINTER FLU VACCINE?

WILL IT BE THERE?

>> Dr. Leana Wen: I THINK ANYONE WHO HAS TRIED TO PROGNOSTICATE THIS ENTIRE PANDEMIC HAS GENERALLY LEARNED THAT THEY WOULD BE WRONG.

AND SO, I WOULD HESITATE TO SAY WAS GOING TO HAPPEN IN A COUPLE OF YEARS' TIME EXCEPT TO SAY THAT IT IS DIFFERENT FROM A STATIC WEATHER FORECAST, RIGHT?

WHEN YOU HAVE THE WEATHER FORECAST, YOU ARE OFTEN WRONG, BUT THERE'S NOTHING YOU CAN REALLY DO ABOUT IT.

I MEAN, YOU'RE NOT GOING TO CHANGE THE DIRECTION OF THE HURRICANE.

IN THIS CASE, WE CAN ACTUALLY PREVENT THAT HURRICANE FROM STRIKING US AND I THINK THAT'S WHY IT'S BEEN SO DIFFICULT FOR US IN PUBLIC HEALTH TO BE WATCHING ALL THESE EVENTS UNFOLD, BECAUSE THEY WERE AND STILL ARE PREVENTABLE.

>> Bonnie Erbe: THANK YOU SO MUCH, DR. LEANA WEN, PUBLIC HEALTH EXPERT AND MEDICAL DOCTOR, OF COURSE, AND AUTHOR OF THE NEW BOOK "LIFELINES: A DOCTOR'S JOURNEY FOR A FIGHT IN PUBLIC HEALTH.

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