Security and Foreign Policy efforts congress as part of this years Aspen Security Forum in colorado. Topics include the russia ukraineore, china, and the blockade on military in the senate. Ues. Host we are joined by dr. Joel zinn berg. A Senior Editor and also the former senior economic general counsel for the council of economic advisers from a trump administration. Welcome to the program. Guest thank you for having me. Host we will talk about your ideas on the reform of the cdc, but lets get an idea of your medical background and that competitive enterprise inches to institute and their point of view. Guest ok i practice surgery in new york city for about 30 years. General surgery and oncology. I have a background in law and Public Policy. I taught at Columbia Law School university on medical and policy issues that involve law and medicine. I worked at the council of economic advisers senior economist and i was general counsel they are as well. I was very involved in helping formulate some of our decision papers and the chapters of the economic support of the president. Currently, i am at that Competitive Enterprise Institute which is a libertarian think tank. It deals with trying to remove unnecessary and harmful bureaucratic obstacles in our economy. I also i am the director of American Public health in america. And the Paragon Health institute which is a new health policy. A Research Center that is trying to improve health and lower costs by empowering patients and encouraging innovation. Host i want to show you a clip from june of this year. This was the outgoing director of the centers control prevention at the time. She had her decisionmaking during the covid19 pandemic and testified in the House Oversight subcommittee. Lets take a look. Guest throughout my tenure is cdc director, i use the facts available and emerging data to inform realtime policy decisions. Rarely did we see new scientific findings that were immediately and unanimously clear. In the cdc, we have a strong commitment to acting quickly with transparency when new science gives us better ways to protect the public needs of the most vulnerable. For example, when two studies were released in march of 2021 where we could reduce the size of schools from six feet to three feet we updated the guidance for weeks after our initial effort. Fortunately, today we know so much more about this virus than we did when it first emerged. In 2023, we believe the darkest days of the pandemic are now part of our history. Despite the important accomplishments and improvements to our Public Health capacities, expandability to collect and share high public data. And Public Health infrastructure, cdc still has more work today to. I have continued to make improvements based on what i have seen. In april 20 22, i address the Lessons Learned from covid19. Increasing accountability and how we deliver information to america. As we continue this internal eternal war we need to better position the cdc for success. In closing, the Infectious Disease warnings that i have seen as director should be a warning to us all. We are once again faced with opportunity. Collectively, we should focus our work on moving the agency and Public Health forward. Our response to the next invention infectious threat response to how we come together and supporting a more prepared america. Host dr. I want to get your reaction to that and i would like to remind our viewers if you would like to call in you can ask lessons and make a comment about this subject of reforming the cdc. The numbers are republicans, to a 274 8001, republicans democrats 202 7488001, republicans 202 7488000, independents 202 7488002, and we also have a line set aside for medical professionals 2027488003. Guest we have responded to many dramatic communications from data and so on. The real pressure is wide. What i did with my colleague of paragon drew keyes was to set out and look at the history and organization of the cdc and look at the pandemic performance to try to figure that out. What we found was a major problem was called mission creep. The cdc has grown into a diverse set of centers and programs disconnected from one another. The most of which have very have very little to do with the mission that is supposed to be combating Infectious Diseases and stopping outbreaks from happening. You have programs that have very little to do with that. Some of them have very little to do with medicine at all. You have a situation where just a small fraction of cdc resources are devoted to combating Infectious Diseases. One has no more than 8 . We think the lack of focus on Infectious Diseases let the cdc unprepared to combat the pandemic. Once the pandemic arrived, they are prepared in combating it. Host your report talks about refocusing the cdc on Infectious Diseases. What other specific recommendations do you have for the cdc . Guest what we uncovered and detailed in great length during the report is there were multiple areas where the cdc was looking at other things through its core mission. Many of the things are actually duplicated in author agencies in a government. For example, the cdc has one of the biggest centers can get chronic diseases. Things like cancer, heart disease, stroke and various other neurological diseases. They are all this same things that are duplicated in other agencies. The nih and there are institutes there that are established before the cdc got into those business areas. They are very wellfunded we are suggesting that you do not need this duplication and it is unknown and distracting. We think that Congress Needs to act and look carefully at what the cdc is, how it is organized, its structure, and as i mentioned, this mention i think was aided by the lack of congressional authorization. What i mean is that our constitutional system, congress has the power to spend. They generally exercise that in a twos step process. They authorize measures that set up or extend or modify programs and agencies. That sets out the goals of the agency, the organization of structure, and followed by an appropriation that provides the funding. Very little of the cdc is authorized. What has happened it has grown up haphazardly with things being a pool from all over the government primarily in the executive branch where the cdc was created not by congress but by the executive branch at the Disease Center in 1946. And it has grown by accretion with all sorts of things being thrown into it that do not belong they are. We think the Congress Needs to go through a hard work of a stepbystep process to authorize agency. Put things in there that belong and take things out that do not and may be moved things from other places in seen in the cdc and also in they need to set up good guidance procedures in the cdc similar to what the fda has. Making sure that the guidance cdc issue is scientifically based. Theres been opportunity for public comment, that people know it does not have Binding Legal authority, just advisory. Primarily setting up to ensure the public that this is scientifically based and it can be relied on. That is a great casualty at the pandemic. It is undermining public trust in the cdc and it has undermined public trust and willingness to follow the cdcs recommendations. Host i want to read you, before we take calls, and opinion by the Public Health professor at george washingtonrsitand have you respond to her comment. What are your views on that and the reduction in funding . Guest the cdc, dr. Walensky referred to this, they did its own review of what went wrong called moving forward. Unfortunately, i think they misdiagnosed the problem they had. They said they had problems with communication this was brought on by insufficient funding and thats the common bureaucratic trope. They say we need more money and what we are proposing is instead of blindly increasing the amount of funding, look carefully at what you need. Childhood vaccinations are very important and the cdc should be focused on that but there is a whole host of things they should not be focused on which is distracting them from the important initiatives like childhood vaccinations. During the pandemic, that moving forward report boasts that in april, 2020 one, shortly after dr. Walensky came into her position as the director, she was bringing on programs dealing with systemic racism and ensuring that Health Equity would be infused throughout these the agency. April, 2021, we were struggling to rollout the vaccine. Less than one in five people in the United States revaccinated. Thats when the cdc should be concert fitting on vaccination, not rolling out trendy things like social justice and Health Equity and they shouldnt be concentrating on other things, things we detail in the report like Climate Change in gun violence all of which may be important but they really arguably dont belong in an agency that is supposed to be protecting the country from Communicable Diseases. Host lets talk to the callers. Id is up first, independent in georgia, good morning. Caller good morning. I im curious if your guest took time to think about the impact of the trump decision to close the Pandemic Response office in the cdc that they had the ability to respond effectively. Im also wondering if your guest honestly believes that two of the most pernicious diseases in our american society, racism and greed are not worth studying because in my mind, they definitely impact things like Health Equity. When more women of color are dying in childbirth and people are not supposed to have dish are supposed to have healthy lives and access to health care, it seems like things we really should be considering and im curious about how this analyst sees all of these issues. Host what do you think . Guest thanks for that question. The reality is, there is this canard that somehow a Pandemic Response unit was shut down and its the discussion the centers around the National Security council. I was there. I was at the white house during that time and the folks at the National Security council who formerly were in this Response Unit didnt go anywhere. They were in the unit. One of those people approached us at the council of economic advisers about doing a study dealing with vaccine innovation to combat upcoming pandemics. We were looking at influenza back in the summer and fall of 2019 but we issued a report dealing with vaccine innovation to combat upcoming pandemics and we talked about how there was a need for Public Private partnerships. Thats precisely what happened in operation warp speed. The end result of that is that you had a new vaccine in 10 months time which is an unprecedented short period of time to create a new vaccine for a novel disease. There is nothing wrong in that regard to what was going on in the trump administration. Its just not true that there was some dismantlement of an important Pandemic Response unit. Your caller talks about all sorts of important priorities. And they are important but the point is, do they belong in an agency whose primary mission should be combating Infectious Disease and combating upcoming pandemics . I would argue no, they dont and they distracted the agency from performing the functions properly. We all suffered as a result and what we need to do is refocus the agency on those priorities so that when we have the next pandemic, and there will be one and i can tell you when but there will be a new pandemic. So that we are prepared to combat it. Host i wanted to show a reuters article about that claim about trump firing the entire Pandemic Response team in 2018. That has been determined as partly false. Alan is calling from east chicago, indiana, democrat, good morning. Caller good morning and thank you for having me on. I am a big fan of this show. I appreciate the opportunity to be here. I wanted to ask about the pandemic preparedness Response Team and the plan. I remember trump was asked about that and he said i didnt do that, that was john bolton. Apparently, they did in the head of it left. That was what happens to the plan, i dont know. Because of the tax cuts that trump put in, he had each Department Taking at least a 5 cut in their budget if not more. The health and human the seas the cdc has 16 centers around the world but they got cut back to 10 and one of the centers wuhan, china, before the pandemic . And it had to shut down. It mightve been a mistake in hindsight. I dont know. Finally, with the response, i think it was in response to covid19. He said he was made aware of it and decided not to tell the American Public because we couldnt handle it. Then he called it a democratic hoax. We kind of got off to a slow start with it and he certainly mishandled it all and you talk about distribution, i congratulate them for the warp speed vaccination, yes, wonderful job, fantastic but he had no Transition Team and would not work with joe bidens team because he was mad about the election. He didnt pass on anything to joe bidens people. Host lets get some response. Guest again, going back to the question of cdc funding, the cdc was better funded during these last few years than its ever been in its history. It got a loan in 2020, about 7. 5 billion dollars in additional appropriations which is almost doubling its budget. Its not as if they were strapped for resources. The question is what did they do with them . How did they handle that and the fact of the matter is, if you are distracted from your primary purpose, if you are looking at other things like gun violence and systemic racism when you are in the biggest Public Health crisis of the last 100 years, there is something wrong with that. Im not just saying its completely a lack of focus, there were certainly a level of incompetence and there was also a level of political influence. There is no question at various times, the cdc seemed unwilling to look dispassionately at the Scientific Data on things like School Reopenings and they seemed to be very willing to listen to influence from teachers unions and other Interest Groups about keeping schools closed when it was pretty clear early on that the young people were not particularly susceptible to this disease, being in school did not pose a threat and schools could be reopened. The problem is, as we detailed in another report called freedom wins, the cdc unfortunately abetted the sorts of lockdown measures which we document in that report as having little to no influence on Public Health but they had tremendous negative impact on the economy and on education. Unfortunately, we will have to live with those results of kids who had fallen way behind in reading and math scores were decades to come. Host sarah is a Public Health professional from georgia, good morning. Caller good morning and thank you. I live here in decatur, georgia and im familiar with the work of the cdc and i think your guest, there is always room for improvement and there should be a review of what was done and what could have been done better and i think cdc has made efforts to do that. I think the refocusing on getting cdc back to its roots of Communicable Disease which is true and thats how it started, its history was to deal with that. And talking about other agencies could do things but i think there is real value in what cdc does for other conditions, taking a Public Health approach that is not strictly medical that the other agencies do not do. I know the nih is wonderful at Clinical Research and addressing the basic science of Health Problems but cdc in its support, its mission is to help Public Health and help the public and i think your guest should probably mention the majority of the funding that comes into cdc goes out the door to the states in the local Health Departments for them to have an impact on Public Health and i think that should be knowledge that its not strictly just looking at Communicable Diseases which they have and have a great history of dealing with that and other important outbreaks and diseases in this country. The pandemic, there were lessons to be learned and i think they are working toward that. Strictly refocusing on Infectious Disease would be shortsighted and not help local communities, giving vaccines at the local level. The cdc pays for a lot of those to go out the door, pays for the chronic disease programs that are housed in Health Departments and local areas the other agencies just dont do. Before reforming it and throwing the baby out with the bathwater, i think we should look more at the more recent history of the cdc in the good work cdc has done and some of those areas. Host what do you think . Guest thats a great question. The problem is, the cdc failed in some of its basic functions and you talked about the state and local authority. The cdc had a data system that was supposed to communicate with states and warned them about incoming travelers who should be looked at and potentially quarantined. They were supposed to keep states and local Health Authorities apprised of whats going on. That system was never really functional. It went offline completely in february, 2020. When Public Health authorities at the state level at the cdc what they should do with incoming passengers, they said let them go. This notion that the cdc is informing governments of important things is true. They are supposed to, but they really did a poor job. All of these other things you refer to are important issues. But why should one of the biggest centers in the cdc be looking at chronic diseases, things like cancer, diabetes, arthritis when you have specific institutes in the nih that deal with those, that were established before cdc got into those areas and have bigger budgets in those areas than cdc. Nih, by the way, just like cdc, spends a lot of money sounds a lot of money out the door to researchers and Public Health officials elsewhere. It would seem to me to make sense that making a slightly different emphasis between the two agencies but when i put them together with a belong . Why have the cdc going into areas like gun violence and racism where it has little or no expertise and where there are other agencies involved and where other nonhealth edges other nonhealth agencies are involved to deal with violence and legal issues. Why not have that agency look at it when you have experts in the government presumably in other agencies and you are just duplicating the work there . Its great to say they are doing important work in these other areas, but not if it distracts them from what should be their core function. I think all you need to do is look at the last three years and youll see the cdcs performance was so poor that it needs to be refocused. This is something that Congress Needs to do. And needs to do the hard work of doing this because the agency will not do it on its own. They are rarely willing to reorganize or downsize. The cdc 20 years ago after his poor performance during the anthrax scare, tried to reorganize but it met with lots of institutional resistance and it had to abandon that effort. The cdcs own moving forward document is misdiagnosed what problems are and is not really offering a blueprint for moving forward. Host lets talk to jeff in bayville, new york, independent. Caller thank you. I would like to point out that the World Bank Published a graph taken from Johns Hopkins that compared the mortality of the United States with south korea. The basic take away was that there were five times as many preventable deaths in the United States compared to south korea during the entire course of the pandemic. There were 18 times more deaths in the United States during the first year of the pandemic. This informs us of a lack of what needs to be done to revamp the entire Public Health infrastructure. If we take a look at how this was accomplished, we can learn what we can do to do the same. If we dont take advantage of the evidence there is to get the best outcome, we are really missing the boat and focusing on just the narrow scope of the cdc. Thats an extremely Important Organization and moving the chairs around to make that more efficient is missing the point if we dont actually focus on what actually needs to be done and then work from that point to revamp the entire Public Health system so we fare better in the next pandemic compared to what south korea was able to achieve. Host what do you think . Guest as the question points out, we need to learn from the pandemic experience. As i mentioned, the other study we performed called freedom wins, we looked at we didnt look internationally although we did talk a little in that study about sweden. Sweden was much maligned for not being willing to impose lockdown measures. Sweden kept its schools open throughout the pandemic with no masking involved. Sweden had very little in the way of closures of restaurants or public accommodations and performances and things like that. Yet, sweden did as well as most european countries. What we really looked at in depth was what can we learn this country based on the different approaches, different states took. What many people dont realize is that in this country, Public Health has always been the realm of state and local governments. Its not particularly been a federal function to deal with Public Health. The federal government can perform important things and its supposed to by providing funding or providing data like issuing guidelines. Those are things the cdc is supposed to do but did a poor job. When we looked at the different state approaches and looked at the severity of their lockdowns as measured by an independent index maintained by oxford university, what we found is that taking the extreme approaches of Closing Everything down, places like california and new york took, did not improve your health as compared to a place like florida which was much more open and while they close things down initially, they reopened its schools much earlier than anywhere else with no really bad health effects. They had a much more improved economic outcome and much improved educational outcomes. We can learn from international comparisons. We can learn from domestic comparisons as important we do so. Host lets talk to dana next in frederick, maryland, republican. Caller good morning. I have two questions wasnt the first coronavirus that started a biological weapon used in warfare . The second question is, the three vaccines that we received, isnt there a percentage that it caused some serious medical problems . Thank you. Guest i dont know there is any proof that thats the case. If you are talking about the class of coronavirus, you need to go back to whats called the original sars virus. There was also the mers virus. Thats why the virus thats involved with this covert outbreak is called sarscovi2. Those two viruses, sars and mers were far more lethal thankfully then sarscovi2 prove to be. I did not read anywhere that those were engineered by a weapons. We have a controversy as to where it started. There is a lot of suspicion in some cases wellfounded that it resulted from a lab leak in its possible it leaked from a lab where the virus was manipulated to give a Certain Property that made it more infectious. Unfortunately, we will never really know the answer to that i believe because the chinese have destroyed a lot of data and have been unwilling to be forthcoming with information from the wu and lab. We know from the structure of the virus and we know from the fact that the first people who were ill were some of the workers at that wuhan laboratory. Its highly suggested that this came from the wu him lab. I dont know i dont think it was a bioweapon per se but we have suspicion that it came from a lab. Host cincinnati, ohio, tanya is on the line for democrats. Caller good morning. The first thing i would like to say is to the host. The hostess, im sorry. That is that it is time, definitely time for you guys to do fact checking. I know it cant be done in real time but overnight it could be. People who called the day before, their comments need to be checked because you sat there and read from an official document that said that the pandemic and Communicable Disease office that was set up by obama was disbanded by trump. But your guest went right on saying the same thing that there was never any office like that and it didnt happen like you didnt read anything, like you didnt say anything. Thats why people are so confused. The next thing i would like to say is that the cdc has been politicized. Somebody is knocking on my door oh my goodness we know the whole thing was confused by trump saying that you could use a disinfectant and people didnt know what was going on. What would have happened better if the republicans and the democrats, if the republicans had come over to the democrats and president and actually work on this problem . People got confused from the beginning. They didnt know what to do and what to believe. The whole thing got politicized. Host lets get a response. Guest i think weve touched on this issue of the Pandemic Office and ive addressed that before and the thing you read from reuters address that. The folks in that office remained at the national and they remained doing their jobs and they were available to address the pandemic. There is an important issue with dealing with whos in authority when we are dealing with pandemics and these national emergencies. If theres one thing we learned from covid is that there is a whole host of agencies and there are unclear lines of authority. This is something we say in our report. Congress should be tidying up. You have whats called asper which is an Agency Within hhs and its recently been upgraded to an office within hhs and is supposed to do with Public Health risks and pandemics and take charge. You have that, you have the cdc, you have the fda, nih and dr. Fauci was leading one of the divisions of nih, the National Institute for allergy and Infectious Diseases. That was unclear who was in charge. An important take away from the pandemic has got to be that Public Policy has to be made by the public officials. It cant simply be turned over to Public Health officials. They have their point of view and they have an agenda but they are not necessarily seeing the big picture. They have to be available to advise the president and other decisionmakers but the president and those decisionmakers have to be the ones making the final decision, balancing the benefits and cost of taking certain Public Health decisions when we know they have that economic outcomes and we know they may have bad educational outcomes. Thats part of what i think congress has to do. It has to clarify the lines of authority. Its getting harder and harder because we now have a new office of pandemic preparedness within the white house. A we haverpah which is a new agency the goes along with another research agency, dealing with biologic threats. We have a pleura for ration of agencies all presumably addressing the same issue but its not clear whos in charge or who should be in charge when an emergency happens. Thats part of the refocusing effort we think congress should be involved in. Host lets go to tim bob in california, a medical professional. Caller am i on . Host yes, go right ahead. Caller i think youre doing a wonderful job and good, am a registered certified emergency nurse and navy veteran and now im in Nurse Practitioner school. I read about the singlepayer Health Care System. I was frontline emergency room registered nurse during the pandemic. I dont know where you were but i saw a lot of disinformation amongst my patients and the population thats mostly political. We had the highest infected rates in the state of california , bigger than San Francisco and l. A. County. Im sure you can understand that the fostering of misinformation about the seriousness of pandemics in medicine in general added to that. I am still in the er. The pandemic is not over. Also, the failures of our Systemic Health care system continues on. We continue to see disparities of our poor Health Care System like poorly managed chronic diseases, copd, diabetes, diseases of despair such as fentanyl overdoses and phenyl os and whatnot. I write a lot about singlepayer health care in school. I am sure you have heard of the commonwealth study. Host we are running out of time unfortunately. Lets get a quick response. Guest im not sure exactly with the question is but if the question is is singlepayer health care the solution . No. The leading proposal from Centre Sanders would impose a system that is unprecedented in the world, a system where there is no private Health Insurance allowed and you cannot find that elsewhere in the world, even a place like england where it has its much loved National Health service, about half the population or more has private Health Insurance. So i do not think that is the answer. As far as medical misinformation, that is true, there is medical misinformation from all sorts of places, but one thing we found is that people are actually pretty good at responding to health care threats and they often will respond before government can take action, so many of the times, people are good at assessing if they are at risk, we knew early on the elderly people are at risk from covid and elderly people avoided going to public places, began staying home, began to stay home from going to work. All without Government Intervention and Government Intervention unfortunately in much of health care ends up making things worth worse rather than better as we documented in that freedom wind study. Host doctor, i want to try to get in one more color from a medical professional in philadelphia, pennsylvania. Very quickly, please, ken. Caller good to hear from you and your expertise. I have a few quick points and i would like your quick response. On the masking and distancing issue in the schools particularly, related to risk for the teachers more than to kids a danger. Although when a single kid came down with a multisystem vasculitis from covid, even though it was rare, you have to admit that is a devastating effect and diseases are only rare for people that do not have them. The other key point i want to ask you about was the lack of a push to develop medication for covid early on and no concerted effort was applied to looking at different medications, even in cocktail form. I think that was a great weakness in the cdc effort. I want your response on that. The issue of whether there is a new pandemic on the way, i think it speaks to where covid19 came from in the first place, we need more on the chinese research. Finally, vaccine and their risk, i think we need a concerted effort in looking at particularly cardiac adverse effects from the vaccines. Host theres a lot there. Guest multiple questions. I will try to address one thing that i think is important, that the cdc really failed i thought fundamentally in failing to conduct studies early on during the pandemic when they had the opportunity to elucidate who is at risk, what measures need to be taken, what measures will be effective, what preexisting medication will be effective. This is what they should have been doing but they really were not doing. I do not think it is an accident for example that cdc Data Collection was so haphazard and unreliable that most people in the country began to rely on the Johns Hopkins data board the data dashboard, compiled by graduate student from Johns Hopkins. So they were not relying on the agencies that are supposed to be doing this, and much of the information we got about risks and benefits of different approaches, they were coming from overseas, places like israel, like sweden where they were studying what happens in school. And the schools were open, no masking, and there was no increase in risk to anyone in school. In particular to the teachers. There was no increase in incidence of covid among teachers. Host and dr. Joel zinberg, im afraid we have to cut it out there because we are going to lose your signal. You can find them watch saturday as book tv brings you live coverage of the National Book festival. A former nfl player. Watch the schedule online or book to. Org. The National Book festival Live Saturday beginning on 00 a. M. Eastern on cspan2. A healthy democracy doesnt just look like this. It looks like this. Where americans conceived democracy at work. Systems are truly informed. Our republic thrives. Get informed straight from the sources on cspan. Unfiltered, unbiased, word for word from the nations