Ex-Obama health advisor Ezekiel Emanuel assesses the vaccine rollout
Ex-Obama health advisor Ezekiel Emanuel joins Yahoo Finance to discuss the vaccne rollout during President Biden's first 50 days in office.
Video Transcript
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- And welcome back to Yahoo Finance Live. We're joined right now by Anjalee Khemlani. And Dr. Ezekiel Emanuel is going to join us in a second. But first, Anjalee-- got to ask you, where do we stand in regards to vaccine distribution? Everyone keeps saying there's lots of demand. What's going on with the supply?
ANJALEE KHEMLANI: Well, the supply is ramping up. We know that the administration has prioritized that and has talked about, on a weekly basis, giving us updates on their delivery and the fact that we're expecting even more to come out in the coming weeks as the Defense Production Act and as federal persons have helped these companies really start up and get access to all the supplies and equipment that are necessary.
We know we heard about, you know, increased purchases of doses. And we heard President Joe Biden just say recently that all Americans will have access to vaccines by May. And we know some experts are thinking that the general public should get access by the middle of next month.
- Anjalee Khemlani, thanks so much for that update. We want to continue the conversation. And for that, we want to bring in Dr. Zeke Emanuel. He's an oncologist, President Obama's health policy advisor. Now he's a senior fellow at the Center for American Progress.
And Dr. Emanuel, it's great to have you back on Yahoo Finance. Thanks for taking the time to join us again. You were an advisor to President Biden's transition team on COVID. I'm curious to get your thoughts. Now that we're 50 days into his presidency, what do you think of the administration's efforts so far?
EZEKIEL EMANUEL: Oh, I think they've done a excellent job. I don't agree with every single decision. But I think everyone has to say, look at where Trump was. He promised us all these millions of people would get vaccinated. He didn't succeed.
President Biden said 100 million people with-- or doses would be delivered in 100 days. And he's going to way exceed that level. And so I think he's done an excellent job.
And, you know, probably, as you say, by the middle of next month, May 1, anyone who wants a vaccine will be able to get a vaccine. If we continue on the current path of about two million vaccinations a day, we get to 70% of the American population vaccinated by the middle of July. That's a major, major accomplishment.
- Dr. Emanuel, why do we let the states, the 50 states, have control over the distribution of the vaccine as opposed to a, you know, one-shot or one size fit all from the federal government?
EZEKIEL EMANUEL: It's really, really good question. It's a sort of vestige of federalism. But I think it has proven to be less than effective to do it that way. We have, as you know, a patchwork system, different states allowing different people to get vaccine.
For example, New York has now brought the age down to 60. I can tell you in Philadelphia, at the University-- at-- I'm at the University of Pennsylvania. So I know Philadelphia well. It's still 65 and above, just came down from 75 to 65.
This is a very bad way to communicate and a bad way to do it. We really need to have much more central structure. As a matter of fact, a colleague of mine was arguing for states doing it individually. I said, no, we need a more national structure.
This was two months ago. He just today wrote me an email-- says, you know, I think you're right. We should have had a more unified structure, unified message. We could have gotten everyone together. And we wouldn't have this problem of people feeling like, you know, if I were in New York, I'd already be vaccinated, or whatever. You know, if I were in Alaska, I'd already be vaccinated. It also means that over time, we can get the infrastructure to each state much more upgraded uniformly if we do it more centrally and don't leave it to each individual state.
ANJALEE KHEMLANI: Dr. Emanuel, Anjalee here. I feel like some of these criticisms are what we heard in the aftermath of the flu pandemic. So it'll be interesting to see how we move forward from this pandemic and the learnings.
But I want to turn really quickly to the treatments and testing site because that continues to also be sort of an obstacle. There are no, really, blockbuster treatments. And testing continues to be a struggle, especially for at-home or rapid testing, where we see, you know, around the world, there is a lot more progress there. What should we be expecting now from the Biden administration? And are they up to par?
EZEKIEL EMANUEL: Well, I think-- actually, I totally agree with you that, on the therapeutic side, we have done quite poorly. I wouldn't agree with you that we don't have anything. You know, the British did show that dexamethasone makes a huge difference in reducing mortality. That was a study they did in just a few weeks. They-- we've also seen some of these monoclonal antibodies.
But the real kind of therapeutic we need is an oral therapeutic or a spray into the nose therapeutic that can be done in the outpatient setting that would reduce the chance of hospitalization. And the sad fact is the NIH has not prioritized that kind of research. That's the first problem.
The second problem is how did we get so many vaccine producers in and get them to rush? Well, one of the things we did is to do these advanced purchase agreements-- if your vaccine works, we're going to buy so much-- so that people knew-- manufacturers knew that they would have a guaranteed market. That changes the incentive structure.
And I didn't-- don't think we used that in the same way for all the-- for therapeutics, especially, again, scalable, oral, or outpatient therapeutics. We did, you know, monoclonal antibodies. But those are very hard to scale because they're very hard to produce on a mass scale. They require health care workers to administer them. It's just not an optimal treatment for a disease that's, you know, affected tens of millions of Americans.
We have not done a great job on those things. I totally agree with you.
- Well, Dr. Emanuel, you just talked about centralizing this kind of response. We had that, say, in-- I think it was 2014 to the Ebola scare. But then we dismantled some of the protocols we had in place to protect the country from pandemics. Now those, assumably, will be reinstituted. But what guarantee do we have that a future administration won't ditch them?
EZEKIEL EMANUEL: Oh, we don't have any guarantee. You know, when I-- when President Trump took over, I talked with him and briefed him. He called me. And I went in and briefed him. And I said, among other things, you know, pandemic is a worry. You need a global health person.
And I recommended to him Admiral Ziemer, who headed the president's malaria initiative and did a terrific job in bringing down malaria around the world. I had worked with Admiral Ziemer in-- when he was in that role and I was at OMB in terms of upping our contributions to the malaria program and just getting it to more places. And I thought he was very competent, nonpartisan, really terrific-- a person.
He was in the role attached to the National Security Council. And then they got rid of him. John Bolton got rid of him-- huge mistake. We have to have that as a permanent part of the National Security Council to coordinate it. We now, I think, fully realize that pandemics are a potential national security threat and we need someone monitoring them and being able to respond to them and coordinate the response.
We're also going to need an early warning system much better than we've had. I agree with you. We have a tendency to put in things. And then when nothing happens, which is good, we dismantle them rather than saying, you know, this is like insurance. We're going to pay a small amount for insurance for monitoring the world, for being able to coordinate, for having supplies ready. And that's a good thing that we don't ever have to use it, just like fire insurance for your house.
We need to change our mentality about this, instead of saying that's a waste of money, saying, you know, it's good nothing has happened. We're prepared in case something happen. If we had that, we'd be more like Taiwan and less like, you know, a place that has 20% of all the world's deaths from COVID.
ANJALEE KHEMLANI: Speaking of that, we know that some other countries were better prepared for the pandemic and its response. And we've seen that in the numbers. What could you say about what we've done that we could change for the next time, because, as many health experts, like yourself, have said, there is going to be another one?
EZEKIEL EMANUEL: Yeah. I think most health experts now are really, really exhausted because I think they think, look, the advice we gave a year ago, March and April last year, was really the right advice. You know, we need to speak with one voice. We need to implement all these public health measures. We really need to have a lockdown until we bring the number of cases very, very low and then slowly open up and be able to monitor and intervene with tracing if we actually see some outbreaks.
That's what they've been able to do in other countries. We didn't want to do that. President Trump wanted to get the economy back rolling. Lots of governors wanted to open up rapidly. And what we saw was exactly what happened.
We saw a peak in the spring, then when-- in the summer, when we were out, no peak. And then, because of summer vacation, go-- and a bunch of other things, we saw a big peak beginning in the fall. And, you know, that was just bad behavior. It was not doing what other countries, like New Zealand, like Taiwan, like Australia, like the eastern seaboard of Canada, did. And all of those places had very few cases, drove the cases way down, and, consequently, had very few deaths. And then many of those countries have been able to open up and be perfectly normal, walking around, having full retail.
But you have to get the cases very, very low. You can't stop when you have 60,000 new cases a day and say, oh, we can throw off mask mandates, open up all indoor dining, retail. That's just a mistake. And we're doing it again.
- Let's hope that our doing it again doesn't lead to a resurgence of virus cases. Thank you so much for joining us. Dr. Ezekiel Emanuel and Anjalee Khemlani-- No rest for the weary. I know that you're going to be writing what we've just talked about.
