S1: The following recording may contain explicit language I can’t get more explicit than May with literal say it may.
S2: It’s Tuesday, March 24th, twenty twenty from Slate, it’s the gist. I’m Mike PESCA. It is unclear the exact path the covered 19 outbreak will take, but the genre of this movie is quite clear. It’s like Outbreak Contagion, where the hot zone if were a book. Trump sadly thinks that we’re inside a farce or a comedy.
S3: So now we’re stuck with recasting the Matt Damon part as W.C. Fields. But what can you do? I, however, have been thinking not about a genre or a film, but a specific episode of television to describe the interplay between Trump and his science advisers. It’s Billy Mummy in the cornfield.
S4: Remember this one Twilight Zone episode 73 must-read arrived in the village just by using his mind. He took away the automobiles, the electricity, the machines because they just crashed and he moved an entire community back into the dark ages just by using his right.
S3: Mustnt displeased the child. Must smile and nod and tell him what a good boy he is. When unscientific babble is delivered, we say, Well, actually, Mr President, a vaccine does take longer than that. Or those drugs are not yet tested. Or maybe even well, few ask. I don’t know if eight more days will be enough time to have all the right data. Today in a Fox News special with the Cauvin Task Force assembled on the White House lawn and interviewed by Fox hosts, Dr. Deborah Bourke’s made sure not to be banished from the cornfield.
S5: New York City, Metro, New York, New Jersey, close to New York City. Those rates are coming in in the 28 percent range. Right now, New York, the case attack rate. What we’re talking about, the number of people who are getting infected is four to five times any other place in the. Why is that density popular? I think part of it is density. Part of is the spread that may have happened on metal surfaces like in the subway and people that were in the subway. Part of it may be a large number of people came back after Christmas from Asia that didn’t get caught up in that closure. You blame the governor for that. And part of it could be the Europeans who have come back subsequently.
S3: Did you hear what she said about Trump’s jibe at Andrew Cuomo? Nothing, she said. Nothing. Correct. Non comment. That is how you stay out of the cornfield. And that is maybe how we all stay out of the ICU on the show today. I shpiel about data, optimism and when those two things collide. But first, Andy Slavitt ran the Obama administration centers for Medicare and Medicaid Services. He has a background in health care and in problem solving. He’s been ubiquitous on TV news and on social media and trying to get out the don’t go out message, stay at home. He’s also in contact with White House officials, equipment manufacturers, industry leaders, hospitals. And now you view this interview up next.
S6: Andy Slavitt is a former acting administrator for the Centers for Medicare and Medicaid. Basically, he was the guy who saved health care dot gov. I mean, this is per Al Franken’s telling, but I believe the former senator brought in as a hired gun because he saw it was going wrong, saved the dot gov site, got hired to run Medicare and Medicaid. Now, he is a leading advocate of what several states and cities are also demanding. Stay home saves lives. Dot U.S. is the Web site. There is a hashtag he’s been disseminating helpful information on this pandemic for some time and I’m pleased to talk with him. Hey, Andy. Thanks for joining me.
S7: Hey. So good for you having me on.
S6: So Reading and VOX today, they put a chart of where the U.S. was in terms of outbreak and it was compared to Italy. And it’s not exactly a direct comparison because the illness and the disease and the virus progresses different ways and different countries. But if you market from a certain starting point, when the 100th confirmed case was known till now, I worry that we might be on Italy’s timeline. But they do note that America was less prepared for a pandemic than other countries in the first place. The U.S. is high uninsured rate, high out-of-pocket health costs and low medical system capacity combined to make the country more vulnerable. All those things are true. But is the analysis true? Were we put in a more vulnerable situation by these pre-existing conditions, if you will?
S7: Well, I think all of those things, plus what people would call the illness burden or how much more frequent chronic illnesses here in the U.S. are strikes against us. But I want to come in a second to the fact that what’s in our favor, because we have some things in our favor as well. But I think you can’t prepare for a disaster 100 percent, whether it’s a hurricane, whether it’s a war, whether it’s a tornado. But what you can’t do is you can plan. And what we really didn’t do is plan. And if we had planned, then we would be probably two to three weeks ahead of where we are on getting test kits across the country. So we would be able to know where the virus is, track it. See who’s getting infected. We’ll be certainly not running into this problem of not having enough protective gear for our workers. And the problem with being two weeks behind is it’s not like when you’re two weeks behind in school where you like to two more weeks of work, you catch up.
S8: It’s like being behind with a loan shark where every day you don’t pay, you owe twenty five percent more.
S6: It’s not like being behind from a fixed doc. It’s like being behind a motorboat. And the motorboat is going faster than you can swim. That’s right. Let’s talk about where we are in terms of equipment. There is debate right now about the urgency of the president really calling into putting into place all he can to ramp up production as opposed to just asking businesses nicely and then praising them when they choose to ramp up production. What should be done?
S8: The president has said that he wants to be a wartime president. He kind of tried that label on. And I liked it when I heard it. And I hope you can stick with it. And I and I fear that he’s not a wartime president. What does a wartime president do? A wartime president. No one equips its troops for battle. And we haven’t done that yet. And it does. And they do everything they can to keep the troops from being out of harm’s way. And really, you should think about our frontline health care workers almost the same way you think about our military. Except this isn’t exactly what they signed up for. You know, the other thing they do? They read the maps and they plan ahead and they tell the truth and they’re highly skeptical. And so it’s really not a great time for the say one thing one day. Have somebody whisper something else in your ear and kind of imply the other the next kind of very flimsy advice and thoughts coming off the top of the president’s head.
S7: And I say this not to be critical. I say this for two reasons. One is we have what we have. You know, we can’t navigate the ship from where we wish we were. We have to navigate from where we are.
S8: And so given that what I think to be weakness, the governors and the states and then all of us as individuals have to recognize that and do so much more. Again, whether you are a Trump fan or not a Trump fan, the personal safety of you and your family and your health, the health care workforce depends much, much more on you than it would if we were on top of our game at the federal level.
S6: When you talk to people and you say you talk to people in the White House, are they career people who maybe you’ve worked with? Are they people who are political appointees who still want to tap your brain for the best behavior? And what do they describe as the friction point? In other words, you’re on the same page. They believe. You what is the hurdle in getting it done? Just convincing the president himself or something else?
S9: Yeah. I’m talking to mostly the political leadership and the people on the task force. I think there’s a couple of things. One is just frankly, that they started behind. They started behind for reasons that, you know, I think are the subject me, the subject of history books. Not necessary. We’re spending a ton of time on here. But I think we all know that there was a month and a half or we could have jumped into action where the president felt like this was a hoax. This was a reflection on him and so on and so forth. That was that was valuable. Time lost. It’s further exacerbated by the fact that he has a relatively small, green and loyal staff. So I worked in President Obama’s administration. Each person was smarter than the next. They each provided really in-depth analysis. The president has tons of questions. He was extremely skeptical of any good news. He made sure that decisions got out. I think there’s a different environment there where, you know, the president views bad news as a reflection on him. And so it’s a little bit more difficult for them to manage. You know, he needs to come out looking good. And so people are always trying to figure that out. And then I think at a more substantive level, there’s a debate which I think is a genuine debate. But I’m worried they’re going to land in the wrong place on between the economy and the public health. And that’s a debate where I think Larry Kudlow and some others are on one side, making what I think is a legitimate point in some respects that, you know, shutting down the economy has also has very negative consequences on people’s lives. And therefore, you shouldn’t just do what’s in the best interest of people’s public health. And that’s of argument going on right now. And I don’t think I don’t have a lot of confidence that’s being informed by the best thinking and the best decision making that those are some of the elements is going on.
S6: So you mentioned something about Barack Obama that he was very skeptical of good news, which I had never really thought of. But it seems. Right. It does seem to comport with what I know of him. And then you mentioned Andrew Cuomo, who before this moment had at least a mixed reputation and was always feuding with Bill de Blasio and was even the people who supported him. Maybe no one’s idea of one of the great leaders in America. Now it turns out he might. So putting aside, you know, bashing of the president, what are some aspects of political leadership that should be emphasized in this time? And what are some aspects of political leadership that maybe work in terms of winning an election that are really unhelpful at this time?
S10: I think it begins with giving people the truth in a way that sometimes a hard truth, but also gives people the confidence that we will get through it. So great leaders lift people up when they’re down and they keep people realistic when they’re too euphoric. And so what I think what we want to see is somebody, whether it’s a president or a governor, who beside behind the scenes, when someone says to them, hey, there’s a new drug therapy that could work, who says, prove it to me and remain skeptical until they get that answer and doesn’t stand in front of a microphone and say, hey, some great things about to happen when you know he knows very little and is you know, it’s really a plans for the worst and hopes for the best. That’s what we need. And if it turns out that Andrew Cuomo or any other leader is later on accused of being too negative and too prepared and overdid it, nobody would be happier than Andrew Cuomo if that turned out to be the case. And the really weird thing here is that positive actions are usually usually get reinforcement from them in this particular situation. It’s the opposite. So if you’re in San Francisco and let’s say that everybody in San Francisco sits inside their house all day long, nobody goes out, nobody talks to anybody. People have stuff delivered, dropped off. The cases drop. And that’s actually happening in San Francisco. Cases dropped pretty dramatically. People sit there and go, what the hell are we doing this for? Because I don’t see any problems. And so they let their guard down where as if you could teleport them to New York or New Orleans or Seattle. And they saw what would happen if they hadn’t been staying indoors. They wouldn’t think that way as a leader. How do you communicate that? How do you communicate to people that what they see with their own eyes is not what they should be paying attention to because they have an invisible enemy?
S6: Yeah, in one of his first F FDR and one of his first. Fireside chats talked about unjustified optimism. And it was a phrase I hadn’t thought of for a while, and then I think I heard Doris Kearns Goodwin use it and I am I can’t help but being an optimist. But when thinking about FDR, talking about this unjust, unjustified optimism, normally I would regard this as just a trait without consequences and maybe even a virtue, some sort of happy go lucky aspect of one’s personality that let him through the day. But now, during these times, I see it not as a virtue at all, but as a big vice and potentially very dangerous.
S10: It is dangerous. And I think that, look, the mix is really hard to get right. And I bet I have some sympathy for every leader going, you know, including, believe it or not, Trump, because there is a difficult blend of telling people that absolute truth and not insulting their intelligence that they can’t handle it. Also understanding that if you tell them the truth, they will be more inventive. And if we’re gonna talk in a minute about what are our strengths in a crisis like this, that’s one of them. Our ability to innovate and create and move fast in this country is better than anywhere in the world. And people can’t tap into that if they don’t have a common set of facts. So you’ve got to be able to tell people that hard truths. But you also have to make sure that people and I say this to your audience. I say this to myself. I’m talking to myself as well. And to anybody listening is we can’t let this paralyze our lives. We have to understand that throughout history people have gone through this. You know, we had our Rosie the Riveter era on the heels of the speeches given by FDR. We had people making real sacrifices. We did things for others that were contagious and just became norms. And those are beautiful things. And if someone can spread some joy and laughter to someone who is going through either economic uncertainty or quite, quite frankly, just just tremendous anxiety, that’s something you should do. And because this period will end. The only question when it ends is how many lives will be lost and what did we do during the process? And if doing everything you can is dropping off soup next door to someone and writing a note that says, do you love them and you’re thinking about them and that you would have never in a million years done before do that. And, you know, and it feels pretty good. And, you know, there are positives to getting through this. But, you know, I’ve I’ve got my entire family home in the house with me, which I wouldn’t otherwise have because my son’s home from college. Now, that’s a hardship for him, but it’s great for me because I get to see my son.
S3: Andy Slavitt was the administrator of the Center for Medicare and Medicaid under the Obama administration. He has a new podcast coming out. Guess what? It’s on the Corona virus. It’s called In the bubble. Look for that. We’re better. Podcasts are served. Thank you so much, Andy.
S7: Thank you so much. Good luck. Stay. Stay. Well, and we’ll get through this.
S3: And now the schpiel, the death toll from covered 19 in Italy was seven hundred ninety three deaths on Saturday. But then there were two days where the death toll with. But then there were two days where the death toll was in the six hundreds each day, which led to analysis like this. While official figures from Italy offer a glimmer of hope, that from d.w News, the English language version of the German broadcaster, they interviewed Italy’s deputy health minister, Pier Paolo Solari, and they again led with the optimism.
S11: I want to ask you about this report that Italy has now seen a drop in daily deaths and infections for the second day in a row. Do you think that the worst could be over?
S12: I know. The lawsuit is over, no doubt that there is a decrease of the number of the infection and these is due to the taxation that were made between the eight and the nine health marsh and entity after the lockdown of the entire E-day. This means that probably we would see a decrease over the next few days. I believe that probably those two days. Yes. Or the day before yesterday and probably today we will see this drop. And ultimately it would be like these for the next few days.
S3: Sadly, it didn’t come down because today the death toll in Italy was three. The deputy minister said he didn’t know if it would drop, but he hoped so. The news seemed to be ahead of the facts in terms of attitude. I’ve been thinking a lot about optimism. I am optimistic. I’m optimistic person. It is my nature. I can’t help it. But I think mostly it’s backed by the facts. Perhaps most optimistic people will tell you this, but just as Emmerson warned against a foolish consistency, there is such a thing as a foolish optimism. FDR warned against a foolish optimism in his first inaugural address.
S13: Unemployment isn’t a grim problem of existence and an equally great number. While only a public optimist can deny the dark realities of the moment and unfortunately we have a foolish optimist in the White House, optimism isn’t bad.
S3: A foolish optimism is bad. Hope isn’t bad. The deputy minister from Italy there was hopeful the numbers would go down, but he couldn’t have been particularly optimistic as to believe they would go down. In our interview today, you just heard Andy Slavitt talking about his recipes for the moment, but also his time in the Obama White House. And as you heard, he talked about Obama’s comportment and that aspect of him that I never considered. Obama wasn’t a pessimist, but he didn’t cling to good news as if it were personal validation. It was a sign of his security as opposed to his insecurity that he was able to do this. An insecure person might have to see conditions as always being good, lest they redound to his criticism. You hear the way Trump leads with hope, the way he brushes off the possibility that calamity is a real thing that can happen to real people. Well, some calamities he embraces mostly the fictional ones like caravans from Mexico, but actual scientifically proven viruses. Oh, no, those can’t happen. Those numbers are going down. And when they do happen, let’s talk up the possibility of an anti-malaria drug fighting corona virus. Sure. Let’s endorse that. Did you hear about what happened to this Arizona couple who heard Trump talking up this possible treatment, saying this drug called chloroquine?
S14: And some people would add to it. Hydroxy hydroxy calorically show chloroquine or hydroxy chloroquine.
S6: So the two people in Arizona did this.
S15: The hospital system, banner. Health reported on Monday that an Arizona man in his 60s died after using Korwin phosphate in an attempt to self-medicate the Corona virus. His wife also attended self-medicating and his currently under critical care.
S3: What they ingested wasn’t the tablet form. It wasn’t what Trump was talking about. But maybe you shouldn’t have been talking about it at all. Loosely an honored form adley about this non-approved treatment. Then you wouldn’t have to angrily deny responsibility when confronted with this endorsement.
S14: If things don’t go as planned, it’s not going to kill anybody.
S3: But he was optimistic, optimistic about the chances of this drug success, optimistic with no medical background, no knowledge of the quite small trial where I think six of the 20 patients who took the drug experienced some reduction of Corona virus in nasal passages. He was so optimistic that when Pete Alexander asked him about this exact pronouncement, this is what Alexander was talking about when he said, aren’t you giving false hope? He lashed out with your bad reporter to the Arizonans. The president didn’t just give false hope.
S1: He issued a garbled prescription for poison like Jim Jones by proxy, of course. Of course, it’s more on the fools who incorrectly followed his lead. But where he led them was no kind of leadership at all. And foolish optimism isn’t an acceptable mindset or outlook when there is no data to go on. Yesterday in the press briefing, Deborah Burks had this to say.
S16: The president and vice president have asked us to look at every single scenario and every single country, because the more data we have, the more our decisions can be completely data informed. And then this is the kinds of data we’re looking at very carefully, as well as very careful data within the United States of exactly where the virus is. What’s the attack rate? Has it moved out of its more confined geography and really looking at each of those pieces of information? It’s a lot of data to go through.
S1: Then she was asked about Great Britain’s policies and this was her answer.
S16: I haven’t looked at the data that informed that decision, so I can’t really comment.
S1: It was as much an incantation as it was. Information. Data. Data. Data. And she was doing that because President Trump was standing right there next to her, trying to push her off her data and her commitment to data, leading her to places that she resisted going, trying to push his rosy UN empirical outlook on the virus itself.
S17: Will there ever be a time when all of those really angry, angry people who don’t like me much to start off with for now, they really don’t like it? Will they ever be a time when they should full like full to the brim like it used to be, where people are almost sitting on each other’s lap and this whole row over here is packed and now they’re outside wanting to get in. And they’re very jealous of all of these reporters. Will we ever have that again? Or is that something that will be, you know, it’ll look like this forever.
S16: So we’re learning a lot about social distancing and respiratory diseases.
S1: Bless her not to take the bait. Not to say of course, sir. Of course, there will be a time when everything will get back to the way it was. Upon hearing the answer that she gave, the president tried again.
S17: But when the virus is gone, will people be allowed to sit next to each other again? In your opinion, in a tight room with a tie?
S16: You don’t. You have to look and see if we have a new respiratory piece.
S1: In other words, let’s wait for the data. I can understand why the data isn’t a friend to the Italians with six hundred and now over 700 deaths a day in Italy. Realize what they’re going through for the duration of Italy’s involvement in World War 2. The country averaged around 200 deaths a day. Civilian deaths and military deaths combined. Yes, that was an average. It was over many years. It adds up to about 150000 or so Italians dead. The novel coronavirus has yet to kill 7000 total. That’s all true. But it is also true that every day, day in, day out, for the last couple of weeks, it has been triple, almost quadruple the amount of deaths that an attack chief antagonist in World War 2 was experiencing. And that’s just data and there is no avoiding it. In his second fireside chat, FDR spoke of a cousin of foolish optimism when he said this.
S18: I do not want the people to believe that because of unjustified optimism, we can win. Look. Ruina tactic of increasing crop output and factory output in the hope that a tiny problem will find via the Pied Piper here that unjustified optimism could lead to ruinous economic production.
S3: And the President did not want people to believe it could. Optimism isn’t actually a virtue. It can be a vice. And when optimism is unfounded or unjustified or wild or foolish, it could be worse than a vice. It can be a death sentence.
S2: And that’s it for today’s show. Priscilla Lobby is the just associate producer at the end of the 15 day period. There will have been a fortnight plus the 14th of a fortnight. She notes Daniel Schrader is the just producer. I don’t know if we’ll ever be shoulder to shoulder again in the office waiting on the data for that one. The gist, no matter what you hear the president say, please, please do not try to cure cancer by rotating a windmill counter-clockwise. That will not work. Please whooper adepero Jabara. And thanks for listening.