What was your greatest disappointment?
My greatest disappointment was the lack of consistency of public health messaging and the inconsistency of civic leaders to reinforce the public health message. You can read between the lines what that means — “civic leaders.”
While the exact order of vaccine recipients may vary by state, most will likely put medical workers and residents of long-term care facilities first. If you want to understand how this decision is getting made, this article will help.
Life will return to normal only when society as a whole gains enough protection against the coronavirus. Once countries authorize a vaccine, they’ll only be able to vaccinate a few percent of their citizens at most in the first couple months. The unvaccinated majority will still remain vulnerable to getting infected. A growing number of coronavirus vaccines are showing robust protection against becoming sick. But it’s also possible for people to spread the virus without even knowing they’re infected because they experience only mild symptoms or none at all. Scientists don’t yet know if the vaccines also block the transmission of the coronavirus. So for the time being, even vaccinated people will need to wear masks, avoid indoor crowds, and so on. Once enough people get vaccinated, it will become very difficult for the coronavirus to find vulnerable people to infect. Depending on how quickly we as a society achieve that goal, life might start approaching something like normal by the fall 2021.
Yes, but not forever. The two vaccines that will potentially get authorized this month clearly protect people from getting sick with Covid-19. But the clinical trials that delivered these results were not designed to determine whether vaccinated people could still spread the coronavirus without developing symptoms. That remains a possibility. We know that people who are naturally infected by the coronavirus can spread it while they’re not experiencing any cough or other symptoms. Researchers will be intensely studying this question as the vaccines roll out. In the meantime, even vaccinated people will need to think of themselves as possible spreaders.
The Pfizer and BioNTech vaccine is delivered as a shot in the arm, like other typical vaccines. The injection won’t be any different from ones you’ve gotten before. Tens of thousands of people have already received the vaccines, and none of them have reported any serious health problems. But some of them have felt short-lived discomfort, including aches and flu-like symptoms that typically last a day. It’s possible that people may need to plan to take a day off work or school after the second shot. While these experiences aren’t pleasant, they are a good sign: they are the result of your own immune system encountering the vaccine and mounting a potent response that will provide long-lasting immunity.
No. The vaccines from Moderna and Pfizer use a genetic molecule to prime the immune system. That molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse to a cell, allowing the molecule to slip in. The cell uses the mRNA to make proteins from the coronavirus, which can stimulate the immune system. At any moment, each of our cells may contain hundreds of thousands of mRNA molecules, which they produce in order to make proteins of their own. Once those proteins are made, our cells then shred the mRNA with special enzymes. The mRNA molecules our cells make can only survive a matter of minutes. The mRNA in vaccines is engineered to withstand the cell’s enzymes a bit longer, so that the cells can make extra virus proteins and prompt a stronger immune response. But the mRNA can only last for a few days at most before they are destroyed.
You can see that different parts of our society have different perspectives on what needed to be done. Controlling the pandemic was always, in my view, aligned effectively with maintaining the economic health of our nation. It wasn’t an either/or — we showed that in schools. You can still keep businesses, hospitals, et cetera, open and do it in a safe and responsible way. There are some parts of our economy that will need to have some restrictions. I would argue that having people in a crowded bar, drinking three or four beers without their masks, talking louder and louder so they spray their respiratory secretions further and further, is probably something that needs to be curtailed.
But the fact that we didn’t have an alignment meant we had the private sector and public sector all wrestling with how to put it together independently. So the reality is we are in for some very difficult times, and I think I would have loved to have been proved wrong. I still believe the worst is yet to come.
Why has the rollout of the vaccines been problematic?
First, we always said that we were going to be for some period of time — probably April, May — we were going to be in a state where demand for vaccine could outstrip vaccine availability. I look at it as an enormous accomplishment that here within, you know, six, seven months, saying we’re going to have a vaccine by the first year, basically two manufacturers are able to produce approximately 10 million doses a week.
What is your response to C.D.C. staff members who say you didn’t stand up for them enough against the White House and the secretary of health and human services?
First and foremost, I stood up for the agency at every turn. I never caved. I think you can find a number of people at the agency that would tell you that, who were actually in the arena with me.
There are people who say to me, “Well, why didn’t you tell the president this?” or, “Why do you tell the president that?” There are some people that will only be satisfied if you personally criticize the president. I’m a chain-of-command kind of guy.
But I’m very disappointed that some civic leaders decided to make this issue of mitigation a political football, rather than embracing the public health measures. It took a long time to really finally get through, I think, and have more consistency of messaging — probably not until late September.