S1: Well, this team has unmatched experience and accomplishments, they also reflect the idea that we cannot meet these challenges with old thinking and unchanged habits. For example, we’re going to have the first woman lead the intelligence community, the first Latino and immigrant to lead the Department of Homeland Security and a groundbreaking diplomat at the United Nations.
S2: The Department of Homeland Security has a noble mission to help keep us safe and to advance our proud history as a country of welcome. I think it’s going to be important to recognize that the confidence that our allies had in the world had in American leadership is not going to be restored overnight.
S3: Hello and welcome to Tramcars Time, Virginia Heffernan. Joe Biden has won the election and Trump has lost both for the hundred and forty second time in a week. And this time for the first time, Trump well and truly knows that even if he can only talk and strange tweets about protocols. And nevertheless, yes, I’m referring to Trump’s two tweets on Monday and I want to focus on that word. Never the less Trump begins his to tweet thread by thanking Emily Murphy, the enigmatic Bartleby the scrivener of the General Services Administration, who you’ll remember when confronted with doing her job, that’s ascertaining who the next president will be said, I’d prefer not to. Well, finally on Monday, she said in a sulky letter that she’d petulantly pushed the paper forward and Biden and Harris could begin their transition and start getting us out of the dire straits Trump got us in. Anyway, Trump thanked Murphy for her loyalty to him, I mean, our country, and then complained about how besieged she’d been by people asking her to do her job. I know I personally got a bounce back when I emailed Emily the Scrivner at her government email address asking that she sign. So I guess I’m not one of the harassers. And it seems she also blocked me on Instagram and Tic-Tac. But I digress. Anyway, Trump then tweeted, Our case strongly continues and we will keep up the good fight and I believe we will prevail. Nevertheless, never the less blather, blather, blather. I’ll ask Emily to do what needs to be done with regard to initial protocols and have my team do the same. But it’s the nevertheless that’s key. Remember when Trump said he wanted to ask the president of Ukraine to, quote, do us a favor, though, unquote? Well, that suggested a turn that though a kind of conditional and now we get the same kind of turn using the word never the less, and he can’t undo that. Nevertheless, Trump thinks he’ll prevail. Nevertheless, he won’t. So congratulations to Biden Harris, who keep on winning every Janki coup effort and nevertheless have been disciplined and focused and can now begin the transition from Trumpy and Maddis to stability, sanity and maybe even a dash of serenity. My guest today is Andy Slavitt. He’s a former acting administrator of the Centers for Medicare and Medicaid Services, a position he held from March 2015 to January 2017. And he also hosts the terrific podcast In The Bubble. Andy, welcome to Dreamcast. Thank you, Virginia. So you’ve been a steady hand, surprisingly steady hand on the wheel for me and for many other people throughout the pandemic. So thank you for your service.
S4: First off, the both of you, thank you some my aunt Peggy Loughlin, who was a wonderful woman who actually had worked with polio victims early in her life, died of covid-19 in May. That was the first wave. And now we’re coming to the second wave. I sort of got used to ultimately how to deal with the mobile morgues outside my house in Brooklyn in the spring and the constant wailing of sirens. But I guess I want to ask you, now that we’re approaching another time like that, what can what we can expect this winter?
S5: Well, the problem was and I’m so sorry about your aunt. Thank you. So sad. That’s hard. Is it really? Nobody who didn’t witness the sirens personally actually believed it. Hmm. You know, we just we have this very literal people, apparently country where the people in Texas and Florida, while New York will do this, one would think they would say, oh, let’s protect ourselves, so let’s just come here. Instead, they said they patted themselves on the back and said, aren’t we smart? This is a weather. They said it was a blizzard problem or whatever they said. And then it continued to happen throughout the year as the virus does. What viruses do goes to find places where it hasn’t been before and where you used to travel and it makes landfall. So, you know, I was calling governors over the summer and up north and they’re like, hey, you look fine here in Minnesota, Wisconsin, nobody’s going there and people are outdoors, more attractive states. Maybe you’d get more virus, but people in the south know they’re indoors because of the wind and because of the summer. And now the exact thing is happening here. Winter. Some of the differences in this wave are one. It is pretty much the national right now. Second is the first wave was very urban and then maybe some bedroom communities. Now it’s urban, rural, and the spread is now happening. Small family gatherings. And we know we know a little bit more now than we do in the spring and. Remember, we thought we couldn’t touch packages, right? Turns out the addresses were OK, but the thing aerosols in a pretty bad way, meaning if you walk out of a room and you had covid and it’s a small room with very well ventilated by the work in there, eight, 10, 12 hours later, I could stay there for a little while. I could inhale your your CO2 and get the virus.
S4: So trillions of my qaid pathogens.
S5: Yeah. So be careful. Yeah. Yeah. So it’s particularly dangerous now that we’re all indoors.
S4: I wonder if your idea that people kind of can’t picture what’s happening in in states that don’t share their politics and culture happening to them, which is just a kind of a sort of astounding state, either of media images or of the kind of just perception crisis in the in the United States that we just don’t seem to share each other’s problems anymore. I wonder if partly that comes from the early idea that this this was communicated by touch that you had to, like, really come into contact with someone that had us aerosolizing everything and using antibacterial everything and that, in fact, this sort of revelation fairly early on, although the news didn’t spread fast enough that it was aerosol, the aerosolized virus, that that that message didn’t get to some of the red states who were less affected. And thus you had this kind of mistaken idea that you could have smoking sections and nonsmoking sections and that smoke one place wouldn’t affect another.
S3: I just know that even Bret Stephens of The New York Times wrote a piece saying, why should Oklahomans, you know, have to do what they do in New York? You know, and that was, you know, overused word, but once again, divisive.
S5: You may be right, but I think it’s probably less literal than that. I think there are kind of mental images that return to France. For one, people in this country tend to think bad things don’t happen here. Hmm. So we see this kind of thing that happens in Africa and in Asia. And so so we have a little bit of a challenge with that. Secondly, I think I may not be right, but I think some of it is race. When we learn that this is happening in black and brown communities and with essential workers, low income of any color, it causes people to say, oh, I feel safer. And it’s a very natural thing. It’s not necessarily just racism, although there’s some of that, too. But there are some amount of oh, it’s not likely to happen to me. And then there’s this notion where it’s impossible to sense the danger. So if you’re in California and you want to know with a bad air day because of the smoke or you can look outside and you can see it on the news, this is a virus that’s invisible completely and it spreads exponentially. And where that plays with your mind is if it were October 1st and now it’s, what, towards the end of November, within that period of time, in many communities, the amount of spread is triple or quadruple. So something that was safe to do in October, maybe go spend 15 minutes in the grocery store is less safe today. The exact same activity six weeks later is less safe. So we’re not used to these kind of cognitive issues. And so it makes it hard for us to comprehend. And then, of course, there’s a whole political element to it. I just don’t believe in it a little believes the vote fraud and all that stuff, too.
S3: That brings me to another question that you’ve touched on in your podcast. And it’s been important to this podcast, which is that many of us have seen in Trump’s rise the axiom of Roger Ailes, the late Roger Ailes, that politics are downstream from culture. But one of the many surprises of this pandemic is that public health appears to be downstream from culture also. I mean, what the hey, masks are a liberal affectation, like avocados or lattes or something. I did not call it.
S5: I’m kind of just want to use it. I was talking last week to the chairman of the National Health System in England. Yeah. And I said, how’s it going? And he said, it’s going really badly, actually. I said, well, what does that mean? People are exhausted. People are really tired. It’s a lot of deadly bacteria into the second wave. And I said, oh, I said political is whatever do you need? I said, well, you know, just one side of this feel one way is that no. I said, well, in this country, like how you react to the pandemic, really. So what kind of American you are? Which tribe you’re in? Yeah. And he said, you know, I had been reading that, but I don’t understand it and I find it impossible to deal with. So here we have people who may not wear masks because they don’t believe they work or they’re interested or they wear them very reluctantly, but has absolutely zero to do with our identity. And I think we sort of jumped the shark when he recognized my belief about Trump is he gets all those ideas from his. Rallies, hmm? These are. You just test what works and you see that image on TV if people aren’t wearing masks that carry a Trump sign, doesn’t want to disappoint the people. And so he goes with it and he gets a lot of response, a lot of Twitter likes or, you know, big boys in his rallies. He found something and literally think that’s how he made this decision. But the decision was really costly.
S4: Yeah, I know. It’s astounding. I mean, just that it became a sharks and jets issue. It’s like, you know, whatever patch you wear. On the other hand, I was telling an English friend of mine, I have no idea how they tell sharks and jets apart when it’s completely random. Who doesn’t wear a mask? I mean, it’s it’s it’s very useful here for just, you know, glaring when you’re deciding who to glare at on the street.
S3: So about a month ago and you were talking about Trump at his rallies, but while he was still campaigning before he was decisively voted out of office, I don’t know if you saw that, but he is not going to be the president anymore, certainly. Yeah, well, he’s still campaigning the soon to be former President Donald Trump, that’s its title now really doubled down on his indifference to the disease. And he had said it is what it is in that interview. And now he started to say, I’ve got to paraphrase this, but something like there’s nothing we could do about covid-19. And he wasn’t even talking about herd immunity or it’ll go away like magic or chicken pox parties or hydroxy chloroquine or bleach in your veins. He was talking about just apathy, plain old apathy. At the time, I thought that he was still saying something that he sort of edged up to saying, which is, you know, none of us, not you, Joe Biden, not me caused this. Right. Like, it’s not our fault that it started. But then I realized he was just saying, I’ve given up on containing this. I’m not going to, you know, go with God, knock yourselves out. I’m not doing this. I’m going to finish out my campaign and then I’m going to go to work on my Q And you guys can die, not die, wear masks, not wear masks, get ventilators, not get ventilators. But I’m out. Did that did you hear him that way? And how did that affect the second wave?
S5: See, first of all, I’m still basking in the beginning of that statement you made that he’s no longer going to be the president of our country any longer.
S3: Yeah, I wanted to break that news here that he’s one for the forty first for the second time as of the Pennsylvania decision. Yeah, it’s pretty great.
S5: Yeah. It’s just so I mean, I was started to grasp what is really just a little tiny in the article that Joe Biden is going to go back and protect the Arctic wildlife.
S6: We get in. And I just got a tear in my eye. Yeah. And I was like, what the heck am I feeling? I’m like, that’s optimism. Yeah.
S4: I hope that sounds like thawing or something.
S5: Yeah. So it’s it’s incredible. So that’s my insight into you may disagree is that it’s all a matter of how it reflects on him. So he says it’s a statement like that. It’s the like what else would you have me do? It sort of like when he said, black people vote for me. What else do you have to lose? If I don’t have to make an effort, I just have to be at the point where I just have to prove that, like, you know, I’m better than the alternative because he never put his shoulder into this. He was unwilling to do that for a couple of reasons. One, that I don’t think he likes the hard words. It wasn’t very true that effectively anything he did, he sense he would get accountability for. So he’d like to do that. Every time there was a whiff of good news, he’d like to do the press conference and say, look what I did. I’d say millions of lives. But whenever there was any bad news, he just wasn’t to be found and they would chase him down. And when when somebody put him down and ask the question, just be like, you know, I have to find a way of demonstrating that I’m doing the smartest thing possible right now. And this is all planned. And so I think it’s I think it’s everything that. Yes, but the impact that had I actually think was in some ways a positive one, because it actually he actually said what we did observe, which is give it up. And you know what? We don’t pay people to give up. When people are dying. People are hurting when people are in need. And I think I was so glad he said that because I thought it was a little bit of like, I’m helpless here. I’m like, yes, you are.
S4: Yeah. And we’re not. Yeah. I don’t know if you saw that Olivia Nuzzi had a piece on basically Trump’s own experience with covid-19, and it started with him saying, am I going to be one of the dayas destress? Do you see this? And yes, a very strange word. Right. And I, I feel like he did part of him did go unlike Boris Johnson, who got the disease and and people say came to Jesus and decided to take it seriously. Trump sort of I don’t know. I think he became like one of the doctors at that point, like or at least his enthusiasm for his press conferences and his hokey quackery and the, you know, strange announcements that it was going to go away soon. And the anti mask and all that stuff just kind of dried up. He just shrunk. I don’t know if his you think his encounter or his sickness did that or if he was just really left, you know, I mean, he’s a guy that just yesterday finally announced in it’s strange prose that he lost the election. And I think he was sort of acting like a defeated almost before that, you know, when I was totally different interpretation.
S6: I think Boris Johnson was truly grateful for the amazing medical care. Yeah. And I think. Donald Trump feels like he has superhuman qualities are why he survived. Look, I think I will give you credit credits, medicine. I think he knows he got good treatment at Walter Reed. I don’t doubt that. But I think he thinks they are immune. And there are people there are a certain number of people who come through this, believe it or not. And I’ve seen this and other people who are like, well, hey, know me so I can do whatever I want. And this is a guy who relishes and I can do whatever I want. Yeah. And so I think he went through that and then I hear this sort of steroid buzz potentially. But after that I think you may be right oxygen for him at these rallies. Like I I’m not going to be told that’s what you do in these rallies. Again, I think that the God knows what happened after that.
S4: I mean, I have another I have another unrelated idea that he’s actually kind of unafraid. There are ways that he has such a morbid way of talking that I think he thinks death like the virus is what it is. That’s what am I going to be. One of the doctors did not look like someone, you know, staring down the barrel of just like life cold, underground and part of his head or no part of his death cult, part of his willingness to let even his supporters die in these huge groups by, you know, drinking the Kool-Aid of coronavirus pathogens is, I don’t know, Slick’s. It really makes me think that he’s some of that rapture discourse of his evangelical followers. And Mike Pompeo kind of soaked in that dying to own the Libs might be somehow the way this ends, we will never know.
S6: But I think that, like he used to keeping score a different way, his way of keeping score is do I get good ratings and I popular. Am I interesting? Can dominate the news cycle, use my wits to come out on top people, other people dying. Yeah. Like, I don’t even score for that. I mean, I don’t I literally don’t think he cares.
S5: I think we saw him like once or twice, slightly moved by something like when the kid in Syria was heard and he saw an image and they decided they wanted to drop a bomb on Syria. And then I think what he had a friend in the hospital, he choked up. But I think he was like, I don’t think it’s a sentimental guy, but I think that’s the closest I’ve seen to him having, like, human expression. And like I talked to David from earlier on this thing, David said, like, literally, it’s impossible to get an independent, but it’s virtually impossible not to get a behi. All you have to do is show like an ounce of humanity. So a little bit of warmth and caring and compassion, which is impossible to do for everybody on the planet. Except, yeah, you literally couldn’t you couldn’t be with us. You couldn’t believe that it would have been much better than nothing that he did.
S4: Well, I want to ultimately get to Biden and Biden’s team for dealing with the pandemic. And Biden, of course, I think is going to be is the opposite when it comes to grief, compassion. Morning. He’s the perfect person. I’ve said on the show to kind of sit shivah with someone or sit at your hospital bedside.
S3: But there was another approach to the pandemic that I don’t think was driven by a particular kind of passion, but by a will to power. And I’m thinking of of Gov. Andrew Cuomo some times, maybe mostly governance is not driven by our sweeter emotions, but by a kind of I don’t know, in his case, a kind of paternalism, a kind of feel general field marshal idea that he was going to save lives. It would redound to his greater glory and he would keep an eye on the logistics, which seemed to fascinate him in his press conferences and ended up fascinating the people of New York. And he managed to rally us to do this thing. And because during Trump Times, we’ve talked so much about toxic masculinity and patriarchy and rape culture, it’s hard to identify that good paternalism. And I may get in trouble for saying this, but there was a way that, you know, Cuomo was always talking about himself as a father, as having his daughters over and kicking the tires of their boyfriends and, you know, having socially distanced times with his daughters. And then also just, man, I loved his press conferences where he engaged our intelligence, our courage to tell us what was next with the ventilator supplies, what he needed in terms of money, how we were doing with the curve, you know, was almost like a video game tuning in each day to say, how are we doing? Made you feel like a hero, that you are just, you know, sitting at home cooking your own food and not getting out of your pajamas and that kind of leadership that may or may not be inspired by Cuomo as being a good person or a bad person. But that’s like that’s why I thought people wanted power that, like, get in the history books that way. And I don’t know if you felt that same way about Kormos leadership. He doesn’t say anything about him in the future, doesn’t say anything about him in other ways, but man, that was like a wartime president in that first wave. I mean, do you agree? That’s what I want from a leader.
S7: Barack Obama used this expression he would use every once in a while if he liked basketball analogies, and he would say that person likes to have the ball in their hands in the fourth quarter.
S3: Yes. Yes. And that guy could be a dick. You know, I don’t think he says he hits heart, bleeds for anyone. I just. But no, but I want to pick up the ball.
S7: And in the fourth quarter, when push comes to shove, like this guy wants to take the shot. And by the way, just to bail you out on the missing part. Yeah. Listen to Undern. Angela Merkel. I mean, there were more women leaders than men leaders who did. It was your craving for Cuomo. Was that because it was the opposite of what we were getting into this level of honesty, truth, straight story, someone showing the human side. And so he’s exposed a complicated guy. And there’s some people, by the way, that are horrible in peacetime and good in wartime. And I’m not saying he’s horrible to defend us necessarily, but that’s the moment he showed because he was very comfortable with the tough stuff.
S3: I mean, you and I were talking before we started about the crown. I got to say, I mean, maybe I’m seeming seeming sentimental now, but that was a very, very difficult time during the APACS to be in New York City. And he seemed almost Churchillian, you know. And I also I felt like I’ve never been led before. Like it was not culture. It was not I mean, I have never been in an army. I haven’t had a coach or like a serious coach, you know. And I like I think I was like, oh, this is what it’s like. You’re looking to the leader, not for his style, not for his fame, not for even his elegance or his lack of neuroticism. Like Obama. You’re looking for him to him for instructions, you know, and that was, I thought, very, very powerful.
S4: And I really actually, for all Biden’s strengths, I really hope that there’s kind of a Cuomo person that we can look to to just tell us what the hell to do.
S7: What you saw in Cuomo is that you trusted him. Yeah.
S5: And what I can say about Biden with I think a reasonable amount of certainty is he combines compassion, competence and a level of experience in tone that, you know, I mean, in retrospect, it may be that he was actually designed by God for this moment. And I say that with whatever you believe in, I mean, I’m being a little bit tongue in cheek, but sometimes that happens. It’s like 20, 20 was a horrible test. And of everything we were made of and everything we’ve been failing at and it got to that point. And by the way, you could get it back there, but we saw what can happen in this country when we just disregard people. And then he comes, this guy who had been a failed presidential candidate twice, nobody thought it was a particularly good candidate. People thought they might have been past his prime. Nobody thought he was a good campaigner. And he just emerged and said and has said and all of the right things and brought in all of the right people. And like, I don’t think Joe’s head will hit the pillow and I’m going to sleep until the country safe again.
S4: You know, I really like hearing that. And, you know, sometimes I think the country is a model for the country. Is Hunter Biden, in other words, broken in recovery and in profound need of Joe Biden? I think hunters like our our American archetype right now. So what do you think of his team? I know you’ve covered some of this on your show, but, you know, I have no reason to doubt and I’ve looked over everything he said. He has chosen a limited range of issues to really focus on in the beginning and for the foreseeable future. And no one is covid. There are only four issues actually on which I really like, which is covid economy, racial, justice, climate. You could do worse, you know. That’s good, right? So what do you think of his team? What do you think of his priority number one, handling the pandemic and what are they going to do?
S5: Well, so this isn’t his first rodeo. He’s been through this with Ebola. He’s been through tough moments. I think he knows how to prioritize and he knows what’s important. And what the team tells me is the question I asked was what? I’ve never done any of the briefings. What kind of questions is he asked if you can learn a lot. And one of the things he asks constantly is if you say something’s happening, he wants to know how that’s affecting people of color. They wants to know how it’s affecting people in rural America because he says, as bad as things are here, go find a rural community with that, with a hospital that’s much smaller and much less experienced, and it’s going to be worse. So he’s looking for the message basically that everybody matters and that’s the team takes away. And that’s so important because the culture gets set. So you do that. Right, and people will never come to you again without making sure that they have. That’s great, right? And having done something so you said you set your priorities that way. Number two, I think we have had an empty bully pulpit, as we’ve talked about. And I think it will be difficult. But he will make progress because I think he wants to be a uniter and he wants to heal the country. And if he is going to say, look, folks, people are going to try to tell you that this is a political thing or whatever, it’s not.
S6: It’s not. It’s just about getting the job done. It’s just about us getting through this.
S5: And that will, I think, have something we’ve got to bring the skills we’ve got to bring the game is what Congress needs to be able to get a package out of Mitch McConnell that supports the public through the remainder of this. Yeah, and that’s going to be difficult. But because the way it tends to work is you don’t get something in Congress unless you give something. Now, Biden is the kind of person that will ask what is it that you want and figure that out more so than anybody else who would be inclined to start, which is what I want. But the flaw in that is possible. Mitch McConnell doesn’t want anything aloof and perhaps to destroy Biden Harris or to not play along. But he is a skilled legislator. He’s going to have to get a deal done, a stimulus deal and a deal that puts money into unemployment and helping small businesses and helping us through the crisis. So if he does those things, then then his operational chops are going to come into play with the vaccine distribution. We can talk about. But we are going to be you know, we’re a couple of weeks away from beginning vaccine distribution.
S4: Amazing. Yeah. So rural hospitals also is something you recently talked about on your show. And I just spoke to a friend who does medical ethics at a hospital in New York and has done a lot of consulting throughout the pandemic on specific issues, ones I hadn’t thought about. So we had heard early on when Meulen locked down and from Italy that they were having to make tough decisions about whose lives to save. And that’s the you know, that’s the terrible sort of Sophie’s Choice moment that we hoped would not afflict us and the US. And Cuomo at least claimed that everyone who needed help, every life they could save, they did save, at least during that first first wave in New York. And who knows about that? But anyway, this ethicist was telling me that they’re really small, interesting things in hospitals, interesting issues in hospitals. The one she cited was that doctors in general didn’t want to do chest compressions and CPR on patients with organ failure who were probably not long for this world because especially chest compressions and CPR release a lot of virus into the air. And if they weren’t going to be saved anyway and so the hospitals would kind of quietly suspended. I shouldn’t say this, that this is across the board, but some of the hospitals in New York City suspended the usual regulation that you follow a family’s orders to not to resuscitate. Or if they don’t have a DNR, then you have to resuscitate them because you need the ventilator. You need you know, and doctors want a lot of leave to make those decisions because these are like these are now very require a lot of creativity and dexterity to solve. And I was interested in that kind of thing that those kind of suspensions go on.
S3: But also at the suggestion that this has become very sophisticated in cities and surely in rural areas, you know, they may still be figuring out how to how to turn a turn someone over so they’re on their belly or the early things or for all I know, they’re still giving hydroxy chloroquine like the gulf between rural hospitals and city hospitals on ethical matters, on just equipment and experience just seems daunting.
S5: Yeah, certainly standard of care and experience. I mean, so Scott Atlus, otherwise known as the Rudy Giuliani of the medical profession, or maybe Rudy Giuliani is the guy in the legal profession, that charlatan and blowhard and. Yeah, completely. I mean, he literally has a law degree and guy that literally has a medical degree. And that’s the qualification that Trump has and seems to seems to agree with the things I’m sorry, Atlas’s.
S3: Is he the D.A.?
S5: He’s a he’s a I don’t know whether that’s the White House doctor is another interesting person, but Ellis is the guy who bumped Pouchy and Burk’s and he sends out a graph like every day or two on Twitter that shows how much how much mass of hospital room there is in the U.S. basically does some analysis which shows how many beds exist. And and then all of the deniers jump all over and say, see, there’s nothing to worry about. Right. And I have this fantasy where Scott bumps into an ICU nurse in New York and tells her, see, there’s nothing to worry about after. For the day, and then I’m just sit there eating popcorn, watching this, I like it right where she like. Yeah, right. In so many ways. So the truth is, you’re exactly right. There are hundreds of subtle ways that are sort of we’re not letting you into the you I mean, just to take it as extreme, OK, let’s say you’re in a hospital and you have one covid patient, 50 doctors, 50 nurses, all the equipment in the world to be a great care second person, third person. By the time you get to a ratio where you’ve got nurses that have worked 20 hour shifts, et cetera, or conversely, you’re in a rural area where you’ve got doctors who’ve seen two Cuban patients in their life and they may know what they read. They may have pulled down some online article. It may not have they may they may have a colleague in an urban center who some people, they may not. But, you know, the death rate on ventilators in rural America is much, much higher than in urban centers. And that’s typical with medicine. That’s not just because medicine is still a practice. It’s not that it requires people to do a guessing game and people make choices like the one you describe all the time. But in New York, if the if the EMT doesn’t get to someone for another hour because they’re so we were so busy in April, you wouldn’t count that necessarily as somebody that they would probably let die. But it was somebody that because of the capacity in New York that happened frequently. But I will tell you, I want to focus a little bit on the positive for the story you told about the chest compressions, the EMT that went out to people’s homes and gave people mouth to mouth all April in New York that you can can you can imagine these people exactly what they were doing. And I know nurses who who who sat and held hands with some people who were highly infectious, knowing that they were themselves exposed. People with kids. There’s so many heroes out there.
S5: And what are they able to not to not get it in both those cases that the people actually got got covid and knew that the reason they go forward is because they were told by the police they worked that they had sufficient PPE and they were describing that they would they would look for surgical masks on the ground to pick up. And because sometimes that’s all they had.
S3: Yeah, it’s astounding.
S4: Back to the point you made about Biden, you know, his focus on people of color, people in rural hospitals reminds me that of when the CDC struck various words out of its vocabulary. Trump had words taken out of its vocabulary, just like the height of cruelty. And one of them was vulnerable, which is, you know, we’re in this might makes right administration and we’ve been dealing with it for so long that even just to think about vulnerable populations, vulnerable sick people, as needing our response are requiring responsibility care. Discipline is like it’s like what you said about the Arctic areas that Biden wants to preserve. It’s it’s it takes a whole inversion of, you know, sort of like the kind of punch in the face public discourse that we’ve had for four years. And we do all have to, I think, invest in that, that taking care of the most vulnerable is an obligation, a societal obligation on the question of public health and culture. So, you know, you’re familiar with Ebola and other and other pandemics and epidemics. And, you know, we’d like to think when Biden says, well, I’ll believe science and when you know, those posters that just say kindness matters and science is real, I don’t know. I think in some ways that overlooks the fact that public health is always a sticky anthropological issue. And maybe you can tell me otherwise. Maybe there’s a world where they can where public health can just be conducted free of cultural constraints.
S3: But, you know, even when we are heroes with South Korea that had tests out within a week of the first case and isolated everyone and had people basically in hazmat suits separated them from their families, you know, that’s like what a perfect society would do. But, you know, we’re we’re Americans were freaks. We have ideological battles.
S4: And no wonder we, you know, dealt with it this way. And I’m sure the English, you know, had some kind of stiff upper lip vaccine. I mean, sorry, like the during the Blitz or something where they would just, you know, muscle through it or maybe maybe maybe less so now. But, you know, maybe it was inevitable that it would become this culturally sticky issue even if Trump hadn’t been in power, that we have a.. Maskers and, you know, and now a.. Voxer is who where we’re facing. And is there a way to steer the culture in a different direction?
S7: That’s what it’s sort of with my book. I’m got a book to emerge from Preventible. Yeah. Oh, good.
S5: And it’s sort of where the book is kind of lends even more than the politics is like, you know, at some level the of shows us are ugly. Yeah. Right. I mean it turns the mirror on you in the good too. I mean but there’s a lot more of our ugly that is there every day, but we kind of can ignore it. And it’s sort of like, you know, a lot of indifference in this country. I mean, you know, a lot of indifference to a lot of people dying that, you know, I don’t think I thought we had we have an aversion to sacrifice. My grandmother, like she went three years without drinking coffee during the Depression or World War Two. I can’t go a morning drinking coffee.
S5: Yeah, yeah. I mean, the ten year depression and six year world war. And then people came to this country in chains and people who left this other countries as refugees like they know suffering. And so like, no, I’m sorry, don’t go into a bar with your buddies. Is that suffering into like we have this we are very privileged as a nation and we expect our wealth and our science to protect us. And when it doesn’t fold like a tent. Yeah, I mean, if you rely on one another, I mean, if we were like ten of ten of us in a cave, we would have been like in every other country at ten people in the cave, they’d come by the American cave. You’d be like, yeah, that one strong person is really full and nine dead people. Yeah, right. And that’s kind of would have been that’d be they’d be us. So what do we do with that, like when this thing is over, what do we do with that. And people are like let’s talk about the next pandemic. And you know, what we learned in this pandemic is that a lot of kids have to go to school to get lunch. We learned of this pandemic is that many kids don’t have Internet at home. We learned this pandemic is there are a lot of people on the edge of mental health crises. We learn all of those things. Yeah. And more of things that were true before the pandemic. They were very true during the pandemic. And they’re up to us as to how true they’re going to be after the pandemic. And, you know, this is this is where it takes dialogue. This is where you have to invite people in and be uncomfortable and and. Being able to look at the ugly and say, yeah, this is ugly, but we can fix it and it’s the same ugly, perhaps it’s behind some of the politics that got ugly because, as you said, politics is downstream. But without a doubt, when I look at all you have to do is look at Hong Kong right next to right next to China. Had one hundred as of September. One hundred people died in Hong Kong. Part of it is experience. They’ve been through this before. Part of it is community. And you look at most places in the world, they figured it out. We didn’t have those things. And we also didn’t adapt very well. At some point, as you said, the president and many of us were like, OK, it is going to be easier to just accept all these debts. First they were like, oh, these people are going to die. You guys are fine, we’re going to die. But they’re just people.
S4: Yeah, who cares? And initially, it’s just a demo side. And then also, you know, the the fact that many trumpet counties already have high levels of diseases of despair. And, you know, this is just another one potentially that. Yeah, it just it just there is such there’s such defeatism that is especially sad. But fortunately, the Trump voters were in the minority. We have Biden coming up. And a new interest in the vulnerable, the sick.
S5: One more thing. One more thing, though, just to be trying to be understanding. I do think look, if you’re part of your complaint, if you’re a Trump supporter, you’re just a general complaint is that there are people out there to try to control. Yeah. So tell us what to do. They think they know better. They are there. Signallers uses words, but and phony intellectuals and those games or whatever it is, the just and they sure as hell don’t understand us and they never ask our opinion and they’ve ignored us. So, you know, if you believe any of that, even even a small amount of that, then you go, OK, now they’re telling us to wear masks. They’re telling us first. They told us we had to bend the curve. Right. Then we said, OK, fine, we’re going to we’re going to bend the curve. And then we got past that and now they want us to do something else. Another one is something else they can take to the ball game. And so I don’t think we’ll get there. But the reason I mention that everything is like I don’t think we get there by more fully being able to articulate our. Yes, we got that nailed. Yeah, I think we have to try to understand how it happens and what how it might look from someone else’s eyes.
S3: Yeah, I think that’s right. One of the one of the few things that very early on that crystallized something for me about trumpet’s that I’ve never forgotten is just the the contempt for Michelle Obama because she told told us what to eat, just everything about that. So like extracting all the other anti-Obama spirit, I just suddenly thought, oh, that’s what that’s how her campaign for health was read by lots of Americans telling us what to eat. And my mother’s from Appalachia. She says social workers always came down to tell them to eat less meat, eat more immediate, less carbs, eat whatever while she was growing up that they should not cook their greens as much as they did. And, you know, by the end, you’re just like, get the fuck away from me, you know, like and that that didn’t make sense.
S4: And if, you know, if you don’t want to be told to eat, to drink Big Gulps and eat trans fats, then of course you don’t want to be told to wear masks, not leave your house, keep your kids home. It just is especially controlling. But, you know, Cuomo did a really nice job talking about the strengths of New Yorkers. And there are strengths of Oklahomans. There are strengths of North Dakotans that maybe a good leader could play to and understand.
S3: And he. Beshear in Kentucky. Yes, exactly.
S5: Yeah. To take the point of Churchill said, look, the greatest generation is taken, but the only way we’re going to get through this is if we’re the nicest generation, the kind of kind this generation. Amazing. And he called on Kentuckians to be just kind of one another.
S3: My God, McConnell got lucky to have a Democrat going into the election doing a beautiful job with covid or at least messaging around covid. All right. Let’s talk about the vaccine. So you are pretty bullish on it, it sounds like are on them, I should say.
S5: Yeah. I mean, look, let’s let’s start with every conversation. Just like with first principles.
S6: Vaccines are frickin amazing. Yes. Like the greatest invention. Yeah. I mean, and so, you know, in nineteen sixty three to the year before the measles vaccine, like seven million kids die of the measles in this country.
S5: I mean, like you don’t want to go back to a world where we’re looking at love the vaccine. This is my favorite thing. No vaccines are what are an important part of the world because viruses are a huge part of this world. And on January 11th, we got sent from China, the the sequence to this pathogen. And on December 13th, we’re going to start putting it in people’s arms and a pretty highly skilled basis, that is pretty amazing.
S8: Andy Slavet is a former acting administrator of the Centers for Medicare and Medicaid Services. He also hosts the podcast In The Bubble. Thanks very much for being here, Andy. So great to be here. And that’s it for today’s show. What did you think? Come find us on Twitter. I’m at page 88. The show is at Real Trump Cast. Our show today was produced by Melissa Kaplan and engineered by Richard Stanislaw. Happy holidays. I’m Virginia Heffernan. Thanks for listening to Trump cast.